Flap or graft: The best of both in nasal ala reconstruction

Lindsay, Karen J.; Morton, Jonathan

doi:10.1016/j.bjps.2015.05.036

Cited by 17 publications

(12 citation statements)

References 8 publications

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“…The external nose is one of the most vulnerable sites for skin cancer and is the site with the most complicated structure for reconstruction [ 4 ]. There are numerous methods for reconstruction of the nose, and each method has its own weaknesses and strengths [ 5 ]. Among these methods, a forehead flap has been recognized for its safety and its aesthetically and functionally excellent outcomes by many researchers, regardless of the inconvenience imposed by this 2-stage procedure [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

et al. 2017

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BackgroundFree-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. MethodsAmong patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73.14 years) treated for large facial defects from basal cell carcinoma. Based on operative and follow-up records, we investigated the number and type of flaps used, postsurgical complications, and patients’ post-surgical satisfaction. ResultsTwo and 3 types of flaps were used for 5 and 2 patients, respectively. Most frequently used were nasolabial flaps (7 times in 6 patients) and forehead flaps (once in each of 4 patients). The average follow-up period was 14 months, with no complications—including necrosis, hematoma, or wound dehiscence—observed. Post-surgical satisfaction averaged 4.4 out of a maximum of 5 points. ConclusionsReconstruction using two or more flaps for large facial defects after skin cancer removal using MMS produced satisfactory outcomes while preventing aesthetic problems. Practitioners should consider using multiple flaps when choosing a reconstruction method for large facial defects following skin cancer removal.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

et al. 2017

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“…The most common options for the reconstruction are primary closure for small defects, healing by second intention, partial or full‐thickness skin grafts, and local flaps . However, these techniques have some disadvantages, like varying cosmetic results and new scars on adjacent cosmetic units …”

Section: Clinical Characteristics Of Patients and Clinical Outcomes Amentioning

confidence: 99%

“…The dermofat graft technique does not entail the common disadvantages associated with surgical reconstruction of the nasal ala. First, the fat pad placed on the wound bed provides a biological structure to avoid the collapse of the wound and subsequent retraction . Second, the graft without epidermal layer allows the reepithelialization from the surrounding healthy skin, so it preserves the same cosmetic characteristics.…”

Section: Clinical Characteristics Of Patients and Clinical Outcomes Amentioning

confidence: 99%

The dermofat graft as a novel option to repair surgical defects of the nasal ala

et al. 2019

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“…They found that perichondrial-cutaneous graft survival was better than full-thickness skin grafts (90% vs 72%). In a similar series, Lindsay and Morton described a case series of 21 patients in which the nasal alar defect was reconstructed using the combination of a subcutaneous hinge flap from the adjacent cheek and an overlying full thickness skin graft [26]. …”

Section: Cutaneous Reconstructionmentioning

confidence: 99%

Reconstruction of nasal defects: contemporary approaches

Austin

Shockley

2016

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review There are many well-established principles and surgical techniques for nasal reconstruction. The purpose of this paper is to describe contemporary reconstruction of nasal defects. The unique anatomic features of the nose make this a challenging task. While obtaining an optimal aesthetic result is always the goal of reconstruction, maintenance and restoration of nasal function are of equal importance. Recent findings The first step of nasal reconstruction is a thoughtful analysis of the defect. The best surgical option will provide the patient with an excellent aesthetic result and nasal function. Depending upon the extent of the defect as well as the anatomic site, a local flap, full-thickness skin graft, composite graft, or interpolated flap will provide the optimal result. The decision will depend on surgeon's experience and expertise, as well as expectations and desires of the patient. Many cutaneous defects will require not only reconstruction of the defect, but also cartilage grafts to provide nasal contour and support. Most large or complex defects will require a paramedian forehead flap for reconstruction along with cartilaginous and/or bony support, as well as a lining flap. Summary This article will highlight recent advances in nasal reconstruction and novel modifications of well-accepted traditional techniques.

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Flap or graft: The best of both in nasal ala reconstruction

Cited by 17 publications

References 8 publications

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

Reconstruction of Large Facial Defects via Excision of Skin Cancer Using Two or More Regional Flaps

The dermofat graft as a novel option to repair surgical defects of the nasal ala

Reconstruction of nasal defects: contemporary approaches

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