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Chirurgia 2006 December;19(6):431-4

language: English

Use of local-regional flaps in facial reconstruction

Klinger M., Pagliari A. V., Klinger F., Villani F.

Plastic Surgery Unit, Istituto Clinico Humanitas University of Milan, Milan, Italy


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Aim. Skin neoplasms are very common, with 700.000 new cases diagnosed annually: 77 % are basal cell carcinomas, 20 % squamous cell carcinomas and 3 % melanomas or rarer tumours. The incidence and prevalence of cutaneous neoplasms of the face are increasing and 86 % non-melanoma skin cancers are found in this area. Wide resection is mandatory and often results in large defects. Reconstructive procedures should respect functional and aesthetic units and sub-units of the face. Attention to unit and subunit anatomy facilitates adequate reconstruction with acceptable deformity.
Methods. During a 10-year period 548 patients underwent reconstruction of the face for surgical defects having a diameter of 2.5 to 6.0 cm.
Results. A single flap was employed in 356 patients and a combination of flap in 186 cases. Major complications occurred in 6 cases (1.1%). Minor complications were observed in 15 patients (2.7%).
Conclusions. The goals of skin cancer treatment are: complete lesion removal, preservation of normal tissue and function and optimal cosmesis. Although primary closure is the ideal method of reconstruction for small defects, flap closure provides a versatile and safe alternative In surgical defects closure, optimal aesthetic results are obtained if cosmetic units are preserved and, whenever possible, scars are placed in naturally occurring creases and folds.

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