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A Journal on Surgery

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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


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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