Outcome of flap surgeries in dermatosurgical unit at a tertiary care centre in India with a review of literature

Abstract

Introduction:Flap surgeries are an excellent choice for closing large defects following trauma, excision of carcinomas or removal of large lesions. This article is a prospective interventional study of various flap surgeries performed at a tertiary care centre with their outcome in dermatosurgical unit.Materials and Methods:A total of 35 flap surgeries performed from January 2012 to December 2014 formed part of the study. Data were recorded for each case including age, sex, indications and type of flap surgery and any occurrence of complications.Results:Out of the 35 patients, basal cell carcinoma was the most common indication for surgery in 22 patients, followed by Bowen's disease in five, dermatofibroma in three and porocarcinoma in two. Other indications were squamous cell carcinoma, tuberous xanthoma, myxoid cyst and nevus sebaceous. Rhomboid flap and rotaion flap were done in 12 patients each, V-Y plasty in three patients, advancement flap, crescentic advancement flap and O-Z plasty were done in two patients each, O-Z plasty was done in two patients, A-T plasty and H plasty were done in one patient each. Common complications observed were flap necrosis seen in three patients and one patient developed hematoma on the second post-operative day, hypertrophic scar in one case and recurrence of BCC.Conclusion:Malignant and pre-malignant lesions were common indications in our study. Excellent outcome of flap surgeries promises to be a birdie stroke in the armamentarium of dermatosurgeons.

Management of pre-malignant and malignant non-melanoma skin cancers: A study from a Tertiary Care Hospital of North India

“…Numerous studies have demonstrated the safety and versatility of this flap in many areas of the body. [ 20 ] In a study by Divya et al ,[ 21 ] 8 out of 12 cases (66.7%) operated by the rhomboidal flap method showed excellent results. Our study too yielded substantial results wherein 89.1% of the cases were operated successfully with no complications or sequelae.…”

Limberg flap revisited: for closure of facial soft tissue defects

“…The study notes that smooth contour and scar quality are very important for plastic surgery patients and hence requires the proper execution. [24][25][26][27] Li et al in his series of 48 patients, 25 cases of benign pigmented nevi, with defect of sizes from 0.9 cm to 11 cm were treated with local flaps where 41 patients achieved satisfactory postoperative results. 28 A series of 27 patients who underwent a medial canthal reconstruction with a rhomboid flap showed rapid healing with no complications.…”

Rhomboid flap: Indications, applications, techniques and results. A comprehensive review

“…A single institution experience in 70 patients treated for facial malignancies, revealed local flaps gave the best results and were the first choice of reconstruction of the face. The study acknowledges that smooth contour and scar quality are very important for Plastic Surgery patients [ 26 , [30] , [31] , [32] ].…”

“…Another series of 30 patients of rhomboid flaps healed without any significant complications [ 14 ]. A series of 35 flaps for reconstruction after cutaneous malignancy resection, revealed excellent outcomes [ 31 ]. Tissiani et al published a series of 45 double transposition flaps, where 70% defects were small, with a 15% complication rate [ 24 ].…”