It is well-recognised that recurrent disease can occur following surgery for malignancy in the head and neck region. This is particularly true of basal cell carcinoma in which recurrences may occur over many years and despite the use of different treatment modalities. Reconstruction of large defects may become increasingly difficult and can be optimally managed by free tissue transfer. The authors report a case of basal cell carcinoma that has required treatment for over 20 years, unique in that on five different occasions, free flaps have been used for reconstruction.

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tion, a small application of 'Op-Site' spray being used to reseal the hole in the dressing.All dressings were removed at four days and the wounds inspected by one of the authors regularly. Patients discharged from hospital with the sutures still in place, had their wounds inspected by the district nurse. All wounds were seen one month after discharge from hospital. TABLE I Characteristics of patients entering the trial RESULTSOf the 103 patients who entered, 102 completed the trial and 1 patient who died in the early post-operative period was excluded.Table I shows the characteristics of the patients in the trial including the type of incision and the numbers of clean and contaminated cases.One-hundred-and-thirty-four samples of serosanguinous fluid were aspirated from 71 of the patients (69.6%). Of these, 18 (13.4%) grew bacteria (Table II). SUMMARY'Op-Site' was used as a post-operative dressing in 102 patients undergoing abdominal surgery. The wound infection rate was 7.8% showing that this dressing does not predispose to an increased incidence of wound infection.