Application of combined local flaps in repair of large nasal defects after cutaneous tumor excision / 中华医学美学美容杂志

Objective:To explore the experience to reconstruct large nasal defects with combined local flaps after cutaneous tumor excision based on the aesthetic subunit principle.Methods:From May 2007 to May 2019, based on the nasal aesthetic subunit principle, combined local flaps were used to cover the large nasal defects in 21 cases of nasal tumors that were removed. Among 21 cases, there were 11 cases of basal cell carcinoma, 7 cases of squamous cell carcinoma, and 3 cases of pigmented naevus. The locations were dorsum of nose in 8 cases, nasal side in 7 cases, nasal ala in 5 cases, nasal tip in 1 case, and across two nasal subunits in 17 cases. The area of the defect ranged between 1.3 cm × 0.9 cm and 3.6 cm × 3.1 cm. A local combined skin flap was used to repair the skin defect. The secondary defect of donor site was directly sutured.Results:Among 21 cases, 20 cases acquired complete recovery; 1 case had epiderm necrosis over the far end of the flap achieved healing by the first intention. The nasal defect was successfully repaired in all patients, and the all flaps survived. A total of 21 patients were available for follow-up of 1 to 48 months, no tumor recurrence occurred, and the repaired tissues were well matched to the surrounding tissue, good nasal contour was obtained, and the cosmetic results were satisfactory.Conclusions:Based on the nasal aesthetic subunit principle, the combined local flaps can be used to reconstruct the large nasal defects, and the cosmetic results are satisfactory.

Efficacy of combined local flaps in repair of larger defects in the nasal and perinasal region after Mohs micrographic surgery in 11 cases / 中华皮肤科杂志

Objective:To investigate efficacy and advantages of combined local flaps in repairing large defects in patients with nasal and perinasal non-melanoma skin cancers after Mohs micrographic surgery.Methods:From March 2018 to November 2020, 11 patients with nasal and perinasal non-melanoma skin cancers, who underwent Mohs micrographic surgery followed by repair with combined local flaps, were collected from Department of Dermatology, the Second Hospital of Hebei Medical University. According to the location and size of postoperative defects, flaps were designed based on the nasal aesthetic subunit principle. For large defects that could not be directly sutured or covered by a single local flap, 2 or 3 kinds of flaps were applied in combination, such as kite flap, modified diamond flap, nasolabial skin flap, bilobed skin flap, etc.Results:Among the 11 patients, 10 were diagnosed with basal cell carcinoma and 1 with squamous cell carcinoma, and the area of defects ranged from 2.0 cm × 2.3 cm to 2.7 cm × 3.6 cm. After Mohs micrographic surgery combined with local skin flap repair, all skin flaps survived well without blood supply obstruction, the texture, color and contour of the skin flaps were similar to those of the surrounding normal skin, and no obvious scars were formed. During the postoperative follow-up of 4 to 32 months, no recurrence of the tumors occurred, and the patients was satisfied with the appearance.Conclusion:To repair large defects using combined skin flaps of 2 or 3 kinds after Mohs micrographic surgery in patients with nasal and perinasal non-melanoma skin cancers can maintain the normal nasal or perinasal morphological structure and aesthetic appearance, and yield a satisfactory cosmetic effect.

Wounds repaired by flap transfer after total knee arthroplasty / 中国组织工程研究

BACKGROUND: Wound complications probably result in severe soft tissue defects after total knee arthroplasty, which brings orthopedic surgeon a big challenge. Some treatment options, such as frequent sterile dressings changes, persistent drainage, minor or thorough debridement, negative pressure wound therapy and split-thickness skin grafts, fail to help those quite large and deep wounds around the knee, with exposed fascia or prosthesis, bone, joint, tendon, large vessels and nerve, heal by secondary intention. Under these situations, orthopedic surgeon should consult plastic surgery and propose flap re-construction. OBJECTIVE: To introduce some types of flaps for orthopedic surgeon, so as to help orthopedic surgeon understand and chose flaps logically, and reduce severe consequences caused by soft tissue defect wounds. METHODS: The first author retrieved databases of PubMed, Medline, Wanfang and CNKI for the articles concerning wounds repaired by flap transfer after total knee arthroplasty published before 2019. The key words were "flap, knee, wound" in Chinese and English, respectively. Initially 668 articles were retrieved and 45 eligible articles were included in accordance with the inclusion and exclusion criteria for analysis. RESULTS AND CONCLUSION: (1) Flap reconstruction is widely applied in plastic surgery. It is significant for orthopedic surgeon to recognize the characteristics of each flap. (2) Selecting and designing suitable type of flap according to the three-dimensional structure and position of wounds is helpful for repairing soft tissue defect, reducing the risks of prosthesis exposure, periprosthetic infection, prosthesis removal and even amputation after total knee replacement after total knee arthroplasty.

Early Coverage with Advancement Flap in Laser Induced Dermal Injury on Neck: A Case Report

Burn injury is one of the most common complications associated with laser procedure. A 38-year-old woman underwent laser procedure for skin rejuvenation on her neck at a local aesthetic clinic. At that time, the cooling system installed in the laser machine was out of order without known origin. The patient complained of pain during the procedure, but it was neglected. It resulted in 3(rd)-degree burn involving the subcutaneous fatty layer on her neck. On the fifth day after injury, early debridement and advancement flap was done under local anesthesia. After 7 days postoperatively, total stitch out was done and a 6cm-length linear and transverse scar remained. When deep dermal injury occurs, it will take a long time to heal on its own. Early debridement and advancement flap will be helpful to prevent wide burn scar.

Substitution urethroplasty: Buccal mucosal graft Vs local flaps – A prospective randomized study

Introduction: Urethral stricture is a common condition with varying etiology and management, determined by cause, site and length of stricture. Materials and methods: We presented here a randomized prospective trial comparing dorsal onlay buccal mucosa graft and penile skin flap urethroplasty at our institute over 3 years period. Results: Total 22 patients underwent substitution urethroplasty during this period. The mean age and follow up was 31.31 years and 9 months respectively. The most common cause of stricture urethra was post inflammatory (40.90%) followed by traumatic (36.36%) and balanitis xerotica obliterence (22.72%). Majority had combined penobulbar stricture (45.45%), followed by penile (31.81%) and bulbar (22.7%). The average size of the urethral stricture was 6.81 cm. The most common symptom of presentation of stricture urethra was thin stream (100%) followed by dysuria (80%), frequency (71.42%) and dribbling (30%). Most of the patients underwent surgical procedure prior to presentation; urethral dilatation done in 13 (59.05%) patients followed by visual internal urethrotomy 7 (31.81%) patients and suprapubic cystostomy in 4 (18.18%) patients. Of 22 patients, 10 (45.45%) underwent local flap and 12 (54.54%) patients buccal mucosal graft. Out of 10 local flap technique, 8 (36.36%) patients underwent ventral longitudinal flap and 2 (9.09%) underwent Quartey flap. Out of 12 buccal mucosal graft technique, 5 (22.72%) patients underwent ventral onlay graft, 5 (22.72%) dorsal onlay and 2 (9.09%) tube circumferential graft. Total success rate was 72.72%. Success rate was higher with buccal mucosal graft (83.33%) compared to local flap technique (60%). Among local G. Mallikarjuna, N. Ramamurthy, G. Ravichander, Ravi Jahagirdar, Jagadeeshwar. Substitution urethroplasty: Buccal mucosal graft Vs local flaps - A prospective randomized study. IAIM, 2016; 3(10): 162-173. Page 163 flap technique, ventral longitudinal flap (62.5%) had better results than quartey flap (50%). Among buccal mucosal graft dorsal onlay graft had best (100%) results followed by ventral onlay (80%) and then tube circumferencial graft (50%). Patients with smaller stricture length (2.5-7.5 cm) had better (75%) results. Patients with combined penobulbar (90%) and BXO as etiology (80%) also had better results. Conclusion: The success rate of buccal mucosal free graft substitution urethroplasty is better than local penile skin flaps in patients with anterior urethral strictures.

Reconstruction of Eyelid Defects after Mohs Micrographic Surgery for Skin Cancer of the Eyelid / 대한피부과학회지

BACKGROUND: The reconstruction of eyelid defects is extremely complex because both functional and aesthetic aspects should be considered. Numerous techniques for reconstruction are available for repairing eyelid defects, depending on the size, location, and extent of the defect. OBJECTIVE: This study was aimed at assessing the effectiveness and cosmetic consequences of various reconstruction techniques for eyelid defects after Mohs micrographic surgery. METHODS: Twenty patients who received a diagnosis of skin cancer of the eyelids from November 2005 to August 2009 were analyzed. Among them, 15 patients were treated with a local flap to reconstruct the defective eyelids, and the remaining patients were treated with primary closure. The medical records and photographs were reviewed by two independent physicians, and postoperative results were evaluated. RESULTS: Eyelid defects were reconstructed with various surgical techniques, such as primary closure, transposition flap, subcutaneous island pedicle flap, advancement flap, rotation flap, Tenzel flap, and hard palate mucous membrane graft. The cosmetic results were satisfactory, and 16 of 20 (80%) patients showed good to excellent results. However, one patient developed a sclera show and another patient showed tumor recurrence. CONCLUSION: Many reconstruction techniques can be used for eyelid defects. An optimal choice would be one that is based on the extent, depth, and location of the defect; skin condition and wishes of the patient; and the surgeon's experience. Furthermore, it is important to have an understanding of the anatomy of the eyelid, the basic principles of the reconstruction techniques, and the merits and drawbacks of each technique.

Combined application of multiple local flaps in facial aesthetic reconstruction / 中华医学美学美容杂志

Objective The study combined multiple local flaps to repair small or medium-sized area of facial skin and soft tissue defects,and to explore the advantages of the local flap collaboration repair.Methods Following the partition repair principle and depending on the wound size and location of these defects,the appropriate local flap was selected to cover the wound.Therefore,the incision was hidden and conformed to the face natural contour or skin wrinkles.Results 77 patients were treated in this group,74 cases got phase] healing and the other 3 got phase Ⅱ healing; all were followed-up for 1 to 8 months.The repair flap and surrounding skin had good similarity in terms of color,texture and contour,the incisions were hidden and the scars were not obvious; no tumor had recurred.The face contour and visual effects were good,and the aesthetic results were satisfactory.Conclusions The combined application of several different local skin flap to repair facial trauma defects,can not only reduce the overall difficulty and risk,reduce surgical complications,but also improve the repair quality,to maximize the recovery of facial aesthetic appearance.

Supernumerary Nostril: A Case Report

PURPOSE: Supernumerary nostril, also known as triple nostril or accessory nostril, is one of the extremely rare congenital nasal deformities which includes an additional nostril. Since Lindsey reported the first case of a supernumerary nostril, only 34 cases of supernumerary nostril have been reported world widely. And there was no any domestic case. In the present case, we described a case of supernumerary nostril and reviewed all the literature cases of supernumerary nostril. METHODS: A 10-month-old female patient visited to the authors with an additional nostril located above her right nostril, which had been present since birth. Antenatal history was uneventful and the infant's birth was normal. On physical examination there were no other abnormalities and additional nostril was communicating with ipsilateral normal nasal cavity. We performed fistulectomy and local flap for the correction. RESULTS: After 7 months postoperatively, the patient was doing well. The functional outcome was excellent and the cosmetic result was satisfactory. During the long term follow-up for 8 years, there were no specific problems. CONCLUSION: In supernumerary nostril, preoperative evaluation of other abnormalities is very important and we advocate that corrective surgery can be performed at an early age for patient's psychosocial development.

Supernumerary Nostril: A Case Report

PURPOSE: Supernumerary nostril, also known as triple nostril or accessory nostril, is one of the extremely rare congenital nasal deformities which includes an additional nostril. Since Lindsey reported the first case of a supernumerary nostril, only 34 cases of supernumerary nostril have been reported world widely. And there was no any domestic case. In the present case, we described a case of supernumerary nostril and reviewed all the literature cases of supernumerary nostril. METHODS: A 10-month-old female patient visited to the authors with an additional nostril located above her right nostril, which had been present since birth. Antenatal history was uneventful and the infant's birth was normal. On physical examination there were no other abnormalities and additional nostril was communicating with ipsilateral normal nasal cavity. We performed fistulectomy and local flap for the correction. RESULTS: After 7 months postoperatively, the patient was doing well. The functional outcome was excellent and the cosmetic result was satisfactory. During the long term follow-up for 8 years, there were no specific problems. CONCLUSION: In supernumerary nostril, preoperative evaluation of other abnormalities is very important and we advocate that corrective surgery can be performed at an early age for patient's psychosocial development.

Colgajos locales y pediculados en el manejo de las comunicaciones y fístulas oroantrales / Local and pediculated flaps in the management of oroantral communications and fistulas / Retalhos locais e pediculados no tratamento das comunicações e fistulas oroantrais

El manejo convencional de las comunicaciones oroantrales ha sido a través de técnicas quirúrgicas locales que a través del tiempo aun siguen vigentes para el manejo primario de dicha complicación. La mejoría del conocimiento de la anatomía detallada de la región maxilofacial ha introducido nuevas técnicas con el objetivo de mejorar e incluso tener nuevos alcances con respecto al manejo de las comunicación y fistula oro antrales que con las técnicas clásicas no se lograban. Esta revisión de tema muestra cada una de las opciones disponibles para el manejo de las comunicaciones y fistulas oro antrales con sus indicaciones, técnica quirúrgica y complicaciones...

The conventional management of oroantral communications has been performed through local surgical techniques which over time are still in vigor for the primary management of that complication. The improvement in the understanding of the maxillofacial region detailed anatomy has leaded to the introduction of new techniques with the aim of improving and even obtaining new achievements regarding the management of oroantral communication and fistulas which were not accomplished with the classical techniques. This subject review shows each one of the available options for the management of oroantral communications and fistulas with their indications, surgical techniques and complications...

O tratamento convencional das comunicações oro-antrais tem sido através de técnicas cirúrgicas locais que através do tempo ainda continuam vigentes para o tratamento primário dessa complicação. A melhoria do conhecimento da anatomia detalhada da região maxilo facial introduziu novas técnicas com o objetivo de melhorar e inclusive ter novos alcances com respeito ao tratamento das comunicações e fistula oro-antrais que com as técnicas clássicas não era possível. Esta revisão de tema mostra cada uma das opções disponíveis para o tratamento das comunicações e fistulas oro-antrais com suas indicações, técnicas cirúrgicas e complicações...

Nipple-areolar complex reconstruction: systematic approach

The goal of nipple-areolar reconstruction is to create a nipple that is appropriately located on the breast mound and has adequate projection, shape, color and texture to match the contralateral nipple-areolar complex. Despite various reports of techniques, no single technique is considered as an established method. The common methods of nipple reconstruction consist of composite grafts and local flaps, and the areolar is usually reconstructed by skin graft and tattooing. The authors introduce a systematic approach to select the appropriate reconstructive techniques for nipple-areolar complex reconstruction. If the patient has sufficient projection of the contralateral nipple and is willing to use it as a donor site, the composite graft of nipple is primarily considered. When the composite graft is not indicated, the methods using local flap such as skate flap and CV flap are proposed. Skate flap is best suited to maintain the contour of reconstructed breast mound. Although CV flap may distort the shape of breast mound, the method is popular for its simplicity. For creation of areolar, tattooing is widely performed to minimize the donor site morbidity rather than skin graft. Despite the algorithm of reconstructive techniques, it is important for the surgeon to choose the most familiar technique for superior outcomes. The nipple-areolar complex reconstruction is an integral step in the long treatment journey. Although the techniques of nipple reconstruction seem simplistic, they play a major role and demand meticulous attention to achieve good aesthetic outcomes.

Various Methods of Reconstruction in Nasal Defect

PURPOSE: Nasal defect can be caused by excision of tumor, trauma, inflammation from foreign body reaction. Nose is located in the middle of face and protruded, reconstruction should be done in harmony with size, shape, color, and textures. We report various methods of nasal reconstruction using local flaps. METHODS: From March 1998 to July 2008, 36 patients were operated to reconstruct the nasal defects. Causes of the nasal defects were tumor(18 cases), trauma(11 cases), inflammation from foreign body reaction(5 cases) and congenital malformation(2 cases). The sites of the defects were ala(22 cases), nasal tip(8 cases) and dorsum(6 cases). The thickness of the defects was skin only(5 cases), dermis and cartilagenous layer(7 cases) and full-thickness(24 cases). According to the sites and thickness of the defects, various local flaps were used. Most of alar defects were covered by nasolabial flaps or bilobed flaps and the majority of dorsal and tip defects were covered by paramedian forehead flaps. Small defects below 0.25cm2 were covered with composite graft or full-thickness skin graft. RESULTS: The follow-up period was 14 months. Partial flap necrosis was observed in a case, and one case of infection was reported, it was improved by wound revision and antibiotics. Nasal reconstruction with various local flaps could provide satisfactory results in terms of color and texture match. CONCLUSION: The important factors of nasal reconstruction are the shape of reconstructed nose, color, and texture. Nasolabial flap is appropriate method for alar or columellar reconstruction and nasolabial island flap is suitable for tip defect. The defect located lateral wall could be reconstructed with bilobed flap for natural color and texture. Skin graft should be considered when the defect could not afford to be covered by adjacent local flap. And entire nasal defect or large defect could be reconstructed by paramedian forehead flap.

Reconstruction of a Soft Tissue Defect of the Lateral Ankle with the Abductor Digiti Minimi Muscle Flap: A Case Report

PURPOSE: There are several methods to reconstruct the soft tissue defect of ankle area, including skin graft, local flaps, distant flaps and free flaps. Among them, the abductor digiti minimi (ADM) muscle flap is very useful for local flap coverage and we report a case using this unique and available technique. MATERIALS AND METHODS: A 31-year-old man with lateral malleolar soft tissue defect was referred from orthopedic surgery department. On physical examination, the wound has chronic osteomyelitis with bony destruction and discharge. After wound debridement, we detached the ADM from the head of the 5th metatarsal bone and transposed to the defected area. We placed the meshed split-thickness skin graft over the muscle flap and immobilized it using a tie-over dressing. RESULTS: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for 8 months without any recurrence such as osteomyelitis. In addition, he kept a normal gait and posture with weight bearing on the lateral border of the foot. CONCLUSIONS: We introduce very easy and useful ADM local transfer method and it is definitely indicative in the case of small, linear soft tissue defect.

The Value of Local Flaps in Lower Extrimity Reconstruction

PURPOSE: The aim of this study was to evaluate the outcome and the effectiveness of local flaps in lower extremity reconstruction. MATERIALS AND METHODS: We have performed lower extremity reconstruction with local flap in 14 cases (10 males and 4 females) from May 2006 to February 2008. The mean age was 40.1 years (range, 16~67). The defect site was the tibia in 5 cases, the ankle in 1 case and the foot in 8 cases. The local flaps were reverse flow sural artery flap in 7 cases, gastrocnemius flap in 3 cases, lateral supramalleolar flap in 2 cases, dorsalis pedis flap in 1 case and medial hemisoleus flap in 1 case. RESULTS: All flaps were survived. Venous congestion was developed in 1 case of the rerverse flow sural artery flap but healed with secondary rotational flap. Other flaps were good without any complications. CONCLUSION: If we choose precisely indicated local flap in lower extremity reconstruction, the resultant coverage of defect would be excellent.

Topical Hyperbaric Oxygen Therapy on Composite Graft & Local Flap on Facial Area

Composite graft and local flaps are good modality for the correction of deformatic scars in facial area but there are several limitations in size, shape and graft bed condition. Hyperbaric oxygen therapy is a good adjunctive therapy for the successful take of the composite graft and local flaps by providing high arterial oxygen pressure and hyperoxic state promoting angiogenesis and collagen synthesis. However, it has some substantial risks of systemic oxygen toxicity to central nervous system, lung and eyes, and needs hyperbaric chamber system and high cost. We designed a modified technique for administrating hyperbaric oxygen topically with the use of simple materials and wall oxygen for the composite graft and local flap wound. 8 patients who had undergone composite graft and local flap on facial scar area were treated with topical hyperbaric therapy for average 6 days. Grafts were relatively large in size and all of the graft bed was scar tissue due to previous operation, trauma and burn injury. All cases showed successful result and there was no complication reported. The potential advantage of this method includes fairly low expense, no need for specialized equipment, simplicity of the application and lack of systemic complication. We conclude that topical hyperbaric oxygen therapy was a simple, cost-effective and safe method for the adjunctive treatment to the composite graft and local flaps.

Reconstruction of the Nose with Local Flaps / 대한피부과학회지

BACKGROUND: Reconstructive procedures are required to repair the defects following removal of the malignant tumors on the nose. Local flaps of the nose require careful preoperative planning and meticulous surgical technique because of unique anatomic features and cosmetically central location in the face. OBJECTIVE: The purpose of this study was to investigate the preferred local flap modalities used to reconstruct the defects occurred after removing skin tumors on the nose. METHOD: From January 1995 to June 2001, thirty-nine patients reconstructed with local flaps to repair surgical defects of the nose following excision for the treatment of malignant skin tumors were included in this study. RESULTS: It was clear that the choice of flap is depended on the location of the defect. Defects on the upper two thirds were repaired differently than were defects on the lower one third. Of the thirty-nine patients, twenty-three patients had a tumor on the upper two thirds of the nose and sixteen patients had a tumor on the lower one third of the nose. Used local flap modalities were as follows. Upper two thirds of the nose - transposition flap(56.5%), rotation flap(26.1%), advancement flap(8.7%), subcutaneous island pedicle flap(4.35%) and combining flap(4.35%). Lower one third of the nose - transposition flap(81.25%), rotation flap(12.5%) and subcutaneous island pedicle flap(6.25%). CONCLUSION: Transposition flaps including rhombic and nasolabial flaps were the most useful of all flaps for each subunit.

Facial Reconstruction with Local Flap after Mohs Micrographic Surgery of Basal Cell Carcinoma / 대한피부과학회지

BACKGROUND: Up to eighty percent of all basal cell carcinomas occur in the head and neck region. Mohs micrographic surgery(MMS) was known as an ideal treatment for primary or secondary basal cell carcinoma. The surgical defects after the removal of malignant skin lesions are usually reconstructed with secondary intention, primary closure, skin graft, and local flap. When we reconstruct the surgical defect, we must consider the reconstruction method, defect site or size, recurrence, patient age, general health state, and functional and cosmetic aspects. OBJECTIVE: The purpose of this study was to evaluate the cure rate and the reconstruction method(especially, local flap reconstruction) by the cosmetic unit of the face after MMS. METHODS: From March 1991 to February 1998, fifty-seven patients were diagnosed histologically with basal cell carcinoma on the face at the department of dermatology of our unit. All the tumors were removed with MMS. According to the facial cosmetic unit, we divided the face into nose, cheek, eyelid, forehead, and temple. We reviewed the local flaps after Mohs micrographic surgery of basal cell carcinoma. RESULTS: 1. 50 of the 57 patients(86%) who had been diagnosed as basal cell carcinoma visited our hospital after their tumors increased over 10mm. Only one case among the fifty seven cases having MMS showed recurrence which means cure rate is ninty eight percent. 2. The forty two patients(74%) who had basal cell carcinoma on the head and neck were treated with local flap, ten patients(17%) were treated with primary closure, and five patients(9%) were treated with skin graft to reconstruct skin defect after MMS. 3. Reconstruction of the nose after MMS of basal cell carcinoma : Of the twenty nine patients that had basal cell carcinoma on the nose twenty four were local flap. The large defects were repaired by glabella and nasolabial flap, while small defects were Banner flap, and Limberg flap. 4. Reconstruction of the the cheek after MMS of basal cell carcinoma : Of the twelve patients that had basal cell carcinoma on the cheek ten were local flap. We preferred to reconstruct the cheek with cheek rotation flap. 5. Reconstruction of the eyelid after MMS of basal cell carcinoma : Of the eight patients that had basal cell carcinoma on the eyelid five were local flap. The depth of invasion was limited to the anterior lamella. We reconstructed the eyelid with variable local flap like unipedicle flap, bipedicle Tripier flap, cheek advancement flap, and glabella flap. 6. Reconstruction of the forehead, temple, scalp, and auricle after MMS of basal cell carcinoma : Of the eight patients that had basal cell carcinoma on the temple, scalp, and auricle three were local flap. We reconstructed the defects with scalp rotation flap, glabella rotation flap, and Banner flap. CONCLUSION: MMS is an ideal method for the treatment of basal cell carcinomas in that it provides 98% cure rates and maximum preservation of normal tissue by complete surgical margin control. Because of high cure rates(98%) after MMS, we can reconstruct the head and neck, especially face with the local flap which obtained the desired result functionally and aesthetically compared with other reconstruction methods like skin graft and secondary intention.

Reconstruction of Nasal Defects with Local Flap: Analysis of 7 Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reconstruction of the nasal defect caused by resection of nose neoplasm or trauma represents a particular challenge to reconstructive surgeons. Each tissue defect has to be evaluated individually in terms of the best possible substitution or alteration from both aesthetic and functional points of view. The method of reconstruction varies according to the location, size, and depth of the defect. Of various methods, local Rap is frequently used because the nasal contours are variable with convex and concave surfaces in close proximity, and there is little lax skin from which to borrow tissue for closure, and the skin of the nose has a texture and color not easily matched by skin elsewhere. Of various local flaps, transposition flap and forehead flap are most frequently used for reconstruction of the nasal defect. The authors carried out retrospectively a clinical study on seven cases of nasal reconstruction that used local flaps after resection of malignant tumors of the nose with a brief review of the literature. MATERIALS AND METHODS: A single surgeon's results in seven consecutive patients were clinically analyzed retrospectively. RESULTS: There were no significant complications. Good aesthetic and functional outcomes were observed with nasal defects reconstructed with the local flaps. CONCLUSION: Local flaps were the most useful choice for reconstructive rhinoplasty. Transposition flaps and forehead flaps, in particular, were particularly useful for each cosmetic unit of the nose.