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

Abstract

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.

Reconstruction of large facial defects using a combination of forehead flap and other procedures

“…If large defects are reconstructed with a single flap, increased tension would arise during closure of the donor site; hence, wound dehiscence or hypertrophic scar formation may occur. If the defects are not closed, contractures or large scar formations may occur due to secondary healing or use of skin grafts [ 14 ]. Santos Stahl et al [ 15 ] and Little et al [ 16 ] reported an approximately 5% increase in the rate of skin necrosis after a forehead flap.…”

Suppression efficacy of lignosulfonate/mercerized cotton fiber composite against cancer cell’s activities

“…The utilization of cotton is regular to repel pathogens from the bloodstream. 28,29 Hence, the idea of utilizing anti-malignant agents on cotton fiber will diminish the reactions and harms. Despite the wide utilization of LS in numerous industrial creations, this is the first run through to utilize it as malignancy hopeful medication.…”