Lower Abdomen as a Donor Site for Large Full-Thickness Skin Grafts

Foulke, Evan; Clegg, Devin J; Peters, Daniel A; Heidel, R. Eric; Johnson, Megan; Lewis, James M.

doi:10.1177/0003134820951454

The American Surgeon

2020

DOI: 10.1177/0003134820951454

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Lower Abdomen as a Donor Site for Large Full-Thickness Skin Grafts

Evan Foulke

Devin J Clegg

Daniel A Peters

et al.

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2022

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“…Choosing a skin donor and grafting technique depend on the vascularity, contour, texture, and recipient area. 11,25 The use of the abdominal skin as a donor has its benefit as it may provide a large coverage, tension-free results at the site of the defect, and cosmetically symmetrical result, therefore it is preferred by patients. 25 Overall, the patient in this case report responded very well upon observation.…”

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“…11,25 The use of the abdominal skin as a donor has its benefit as it may provide a large coverage, tension-free results at the site of the defect, and cosmetically symmetrical result, therefore it is preferred by patients. 25 Overall, the patient in this case report responded very well upon observation. There was no major complication following the procedure, and the skin flap and graft were also able to survive.…”

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A Large Squamous Cell Carcinoma on the Face Treated with Wide Excision and Defect Closure Using Forehead Flap Reconstruction

Sutedja¹,

Yuliasari²,

Rizki³

et al. 2022

CCID

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Squamous cell carcinoma (SCC) is a non-melanoma skin cancer, with a rising worldwide incidence. Wide excision with an intraoperative frozen section decreases its recurrence rate and metastases. Case: We reported an SCC case in a 50-year-old woman with clinical manifestations of a 4 × 6 × 0.3 cm solitary ulcer that easily bled. Dermoscopy and histopathological examination support the diagnosis of SCC. Due to its size, a wide excision was initiated, followed by a frozen section being carried out to determine the cancer cell-free margin. We performed an additional 1 cm margin excision as residual tumor still remained in the margin on the first excision. The forehead interpolation flap reconstruction was performed right after the excision to cover the extensive defects on the cheek, followed by a full-thickness skin graft (FTSG) for the forehead. The patient recovered well without complication within eight weeks post-procedure. Discussion: SCC with a diameter larger than 2 cm is considered as high-risk, and a wide excision is the standard treatment in this condition. However, this may risk incomplete excision, leaving residual tumor and increased recurrence rate. Intraoperative frozen section aids the surgeon to determine tumor margin, thus improving the success rate of therapy by up to 95%. A skin graft on the cheek was avoided due to concerns of wound contraction, which may lead to lower tissue survival rates with poor color and texture matching. Therefore, we preferred a skin flap to increase tissue survival and preserve facial contour as well as skin color. Forehead interpolation flap was carried out as it could cover the large size of the skin defect. The forehead skin as donor was later closed by a FTSG. Conclusion: Wide excision surgery with frozen sections is the best option for managing large SCC while a skin flap is preferred to close defects on the cheek.

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confidence: 99%

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confidence: 99%

A Large Squamous Cell Carcinoma on the Face Treated with Wide Excision and Defect Closure Using Forehead Flap Reconstruction

Sutedja¹,

Yuliasari²,

Rizki³

et al. 2022

CCID

View full text Add to dashboard Cite

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Lower Abdomen as a Donor Site for Large Full-Thickness Skin Grafts

Cited by 1 publication

References 2 publications

A Large Squamous Cell Carcinoma on the Face Treated with Wide Excision and Defect Closure Using Forehead Flap Reconstruction

A Large Squamous Cell Carcinoma on the Face Treated with Wide Excision and Defect Closure Using Forehead Flap Reconstruction

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