Postoperative Complications of Paramedian Forehead Flap Reconstruction

Abstract

IMPORTANCE Paramedian forehead flaps are commonly used to reconstruct facial defects caused by skin cancers. Data are lacking on the complications from this procedure, postoperative outcomes, and association of cancer diagnosis with rate of deep venous thrombosis (DVT).OBJECTIVES The primary objective was to determine complication rates after paramedian forehead flap reconstruction for defects resulting from resection of facial cancers; and the secondary objective was to determine patient factors and complications that are associated with readmission.

Complete division of the pedicle of the forehead flap is possible after 1 week of engraftment in selected patients

“…In a recent study of a large cohort of patients (n = 2175), the most common complications of this procedure were postoperative bleeding (1.4%) and postoperative infections (2.9%). 19 Similarly, in our study, we observed postoperative bleeding in 1 patient and a surgical site infection in another patient. In another study, the most common complications were partial flap loss (6/53; 11.3%), donor site dehiscence (4/53; 7.5%), postoperative flap dehiscence (2/53; 3.8%), and surgical site infection (1/53; 1.9%).…”

“…FHF is a very secure method to reconstruct large and complex wounds of the lower third of the nose. 19 The principle of reconstructing the nose with the skin of the forehead dates back to 700 BC. 17 In recent decades, several modifications have been published, 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 which make FHF a workhorse to reconstruct large and complex nasal defects.…”

“…The forehead flap (FHF) is a well-established alternative, with good cosmesis, especially for reconstructing defects of the lower third of the nose. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Different modifications of FHF allow it to be applied for a variety of nasal defects, including those that need cartilage grafting or lining of the nasal ala. 9 , 16 , 17 , 18 It is a safe procedure, with only minor complication rates 19 and can even be used in elderly patients. 20 However, FHF is (at least) a 2-stage procedure, requiring engraftment of the FHF in the recipient's defect bed between the first and second surgical procedure.…”

Paramedian forehead flap reconstruction for skin tumors involving central subunit of face: An analysis of 37 cases

“…8,9 In a recent large retrospective descriptive study of paramedian forehead flaps for nasal reconstruction the most common complication was postoperative infection in 2.9% patients, followed by postoperative bleeding and DVT in 1.4% and ≤0.5% patients respectively. 10 In another series the infection rate was found to be statistically similar between patients undergoing 3 stage and 2 stage paramedian forehead flap reconstruction (5% vs 1%, P = 0.218). Similarly, the rate of partial forehead flap necrosis was similar in both groups (2-stage, 3.4%; 3stage, 5%; P = 0.601).…”

“…Among the various local flaps available paramedian forehead flap is good, versatile and simple, especially for defects involving dorsum of nose, medial aspect of both eyelids and adjacent skin. [1][2][3] Use of paramedian flap does not require a plastic surgeon and can be done by the operating surgeon himself. This saves cost and time.…”