Skip to main content
Back to Journal Club

Twizzler Technique for Scalp Reconstruction - High-Tension Defects

Riopelle AM, Jeong D, Boyd AY, et al.
Dermatologic Surgery (2023)

JC: October 2023

This study described the Twizzler technique for reconstructing scalp defects under high tension, particularly those with limited tissue laxity. The technique uses a rotational advancement approach that distributes tension effectively, enabling primary closure of defects that might otherwise require grafting.

Take-Home Messages

  • •The Twizzler technique provides an effective option for closing high-tension scalp defects that resist standard linear closure.
  • •Understanding scalp tissue biomechanics and tension distribution is key to selecting appropriate reconstruction techniques for large scalp defects.

Topic

Reconstruction

Flaps, grafts, wound closure techniques after Mohs

Related MohsPedia Articles

Recon NoseRecon EarRecon EyelidRecon LipRecon Cheek ForeheadFlaps AdvancementFlaps RotationFlaps TranspositionFlaps InterpolationFlaps Island PedicleGrafts FtsgGrafts Composite

Abstract

Scalp wounds are difficult to close primarily because of the inelasticity of the galea, often requiring adjacent tissue transfer or grafting. It is still debated whether intraoperative tissue expansion can occur on the scalp. We report our experience with the Twizzler technique, a form of intraoperative tissue expansion and load cycling, to achieve primary closure of high-tension scalp wounds. In this case series, scalp defects repaired by the Twizzler were identified and those with minimum 3...

Literature review only. This summary is an editorial interpretation and may not reflect the complete findings of the original publication. Always refer to the full-text article for clinical decision-making.