Reconstruction of cutaneous defects of the nasal tip and alar by two different methods

Kim, Yong Hun; Yoon, Hyung Woo; Chung, Sung‐Kee; Chung, Yoon Kyu

doi:10.7181/acfs.2018.02271

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…Here, we performed PSS with minimal undermining (1–2 mm) on wounds around structures such as the eyelids, the eyebrows, and the nose, which are sensitive to distortion [ 28 , 29 ]. While distortions occurred immediately after the operation, they disappeared as the radiating fold improved, with restoration of the original shapes ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck

Park

Lee

Yeo

et al. 2021

Arch Craniofac Surg

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Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results.Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied.Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1–2 months.Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than theinitial lesion and less distortion of the body structures around the wound in the completely healeddefect. If the operator can predict the process of healing and immediate radiating folds, PSS couldbe a favorable option for round skin defects in the head and neck.

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Section: Discussionmentioning

confidence: 99%

Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck

Park

Lee

Yeo

et al. 2021

Arch Craniofac Surg

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“…Local flap surgery is a common method of reconstructing a defect after resection of the skin cancer if the defect is small and structure distortion is not expected [ 17 , 18 ]. The use of the facial skin as donor sites can be cosmetically superior even when skin graft is required for a large defect.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

Kang

Lee

Yun

et al. 2020

Arch Craniofac Surg

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Background: Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. Methods: We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. Results: We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. Conclusion: In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient's advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

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“…Surgeons with lesser qualifications, or surgeons unfamiliar with surgery of the external nose, should not venture here. 5 , 6 , 8 , 10 , 12 Examples found outside the plastic surgical literature were decidedly poor. 11 , 12 , 13 , 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

“… 6 Fourth, the supratip region must not be depressed. 7 , 10 Fifth, the nasal alae should not be elevated. 8 , 11 , 12 Sixth, the columella should not be used as a donor site, as this obviously narrows the columella, creating an unnecessary deformity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

V-Y Flap for Nasal Reconstruction

Viciana

Lessard

2020

Plastic and Reconstructive Surgery - Global Open

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The nasal tip is a complex zone for reconstruction. Numerous flap reconstructions have been proposed. In addition to the technique presented here, only the Gillies-Millard bishop’s miter flap and the paramedian forehead flap should be considered. The bilobed flap should be discontinued. The double-opposing V-Y flap for nasal tip reconstruction described here is an excellent method for reconstruction of limited defects of the nasal tip. These are mirror-image cutaneous flaps which require careful, skillful technique to preserve the delicate nerves and vessels. This challenging technique should only be attempted by qualified surgeons. Triangular cutaneous flaps are marked on either side of the defect, oriented transversely. The flaps are elevated and advanced with careful, gentle dissection. Ligamentous structures are cut while preserving the neurovascular supply. No cautery is used. The procedure is performed in an operating room with local anesthesia and with the patient under IV sedation. A patient who underwent this reconstruction is shown preoperatively, early postoperatively, and late postoperatively. The results demonstrate no tip distortion with imperceptible scars. The steps to undertake this procedure are outlined in detail. Rules for nasal tip reconstruction are proposed.

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Reconstruction of cutaneous defects of the nasal tip and alar by two different methods

Cited by 6 publications

References 8 publications

Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck

Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

V-Y Flap for Nasal Reconstruction

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