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Tensor Fascia Lata Autograft for Dura and Scalp Reconstruction: A Case Series

Emily Pfahl, BS; Abdulaziz Elemosho, MD; Jude Kluemper, BS; Kerry-Ann Mitchell, MD-PhD, FACS
The Ohio State University College of Medicine
2024-01-15

Presenter: Emily Pfahl

Affidavit:
I certify that the work to be presented was fully done by Emily Pfahl and other members of Dr. Kerry-Ann Mitchell's lab. This work has not been previously published in journals nor presented on in other conferences.

Director Name: Gregory Pearson

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction
Autologous tissue is considered the gold standard in scalp and calvarial reconstruction. Although free flap reconstruction is widely used in complex scalp and calvarial reconstruction, the procedure is accompanied by a high rate of complications. At our institution, autologous fascia grafts combined with local flaps and adjacent tissue transfer are commonly used in complex neuroplastic reconstructive procedures, negating the need for free tissue transfer. The purpose of this case series is to examine the outcomes of patients who received tensor fascia lata (TLF) graft for duraplasty and/or scalp reconstruction with concomitant cranioplasty to repair large-size skull defects.

Methods
A retrospective chart review was performed on patients treated at our institution between January 2023-December 2023. Patients were included if they underwent dura or scalp repair with TFL fascia graft during craniectomy or cranioplasty. All patients had a minimum follow up of 30 days.

Results
Over the one-year study period, a total of five patients underwent dural repair with TFL fascia graft during craniectomy or cranioplasty. For three of the patients, duraplasty was indicated for tumor resection involving the dura. Another patient underwent cranioplasty following decompressive hemicraniectomy for intraparenchymal hemorrhage. One patient required cranioplasty for pervious cranioplasty complications. None of the patients had complications, reoperations, or readmission within 30 days of their procedure.

Conclusion
Autologous TLF graft for reconstruction is a relatively low-cost option for duraplasty. The current study suggests that this method has excellent outcomes compared to tissue substitutes (e.g., synthetic) in terms of complications.

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