Kite subcutaneous pedicle flap design in postoperative defect repair of nasal skin cancer based on partition and blood supply / 中华医学美学美容杂志

Objective:To investigate the clinical effect of repairing postoperative nasal skin cancer defect with subcutaneous pedicle flap based on partition and blood supply.Methods:From March 2018 to September 2020, 39 patients with skin cancer (basal cell carcinoma, Bowen′s disease, squamous cell carcinoma and malignant melanoma in situ) were repaired with kites subcutaneous pedicle flap after extensive resection.Results:Thirty-nine patients were treated with parafasal kite flaps, including 44 cases. The donor sites of the flap were nasal tip in 4 cases, bilateral alar in 7 cases, bilateral nasolabial sulcus in 19 cases, bilateral parasinal in 12 cases and interglabellar in 2 cases. There were no serious complications such as necrosis, hematoma or infection. During the follow-up period of 6 to 24 months, 2 patients complained of occasional tingling in the surgical area, 1 complained of occasional pruritus, and 1 patient had local recurrence of squamous cell carcinoma and underwent surgery again. The scar was evaluated 6 months after surgery, and the scores of Vancouver scar scale and visual analogue scale were 2.42±1.04 and 7.83±1.21, respectively. The skin color of the operation area was similar to that of the surrounding skin without obvious local strain deformation.Conclusions:The subcutaneous pedicle flap designed by considering the nasal division and blood supply has a high survival rate, fewer complications and small local appearance deformation, which is worthy of popularization and application.

Repair of soft tissue defect of digit-tip with single subcutaneous pedicle V-Y advancing flap combined with skin grafting / 中华显微外科杂志

Objective:To explore the surgical method and therapeutic effect of repairing soft tissue defect of digit-tip with single subcutaneous pedicle V-Y advancing flap combined with skin grafting.Methods:From August 2013 to December 2020, 25 soft tissue defects of digit-tip were repaired by a single subcutaneous pedicle V-Y advancing flap combined with pedicle skin grafting. The area of the defects was 0.8 cm× 0.8 cm to 1.6 cm× 1.4 cm. The flaps were harvested from palm or lateral side of the wound and the area of flap was 0.5 cm×1.0 cm to 0.8 cm×2.5 cm. In order to make the flap transfer to a further distance, the subcutaneous fibre connection of the flap was cut-off during the operation. At the same time, cut off 1 side of subcutaneous pedicle. Finally, the advanced distance of the flap reached 0.5-1.2 cm. After the flap harvested, the medium thickness skin was removed for graft to close the donor site from the wrist striations. After the surgery, follow-up visits were conducted regularly by outpatient clinic, or via telephone or WeChat review or by home visit. Throughout the follow-up, the flap appearance, sensation and recovery of the function of digital joint were observed, together with the patient satisfaction. Results:After the surgery, the postoperative follow-up lasted for 4 months to 8 years. All 25 flaps and skin grafts were survived in first stage wound healing. The flaps and skin grafting areas had excellent texture. The fingerprint had been reconstructed with good appearance. The TPD was 4-9 mm, the functions of digital joint recovered well, and there was no complain about a discomfort at the donor site. According to the evaluation standard of Michigan hand function questionnaire, all 25 patients were very satisfied with the overall appearance and function of the hand. According to Total Angle of Motion (TAM) evaluation standard, finger mobility was excellent in all 25 patients.Conclusion:Subcutaneous V-Y advancing flap combined with skin grafting is an ideal method for repairing soft tissue defect of digit-tip. The surgery characterises a simple flap cutting, less traumatic damage, long advancing distance of flap and good repair effect.

Using a Subcutaneous Island Pedicle Flap and Periosteal Suspension Suture Following Mohs Surgery for Basal Cell Carcinoma Involving the Nose and Nasolabial Fold / 대한피부과학회지

Skin cancers usually occur on the face and so successive cutaneous reconstruction after surgery is very important for the patients' quality of life. Cutaneous reconstruction is especially difficult when the defects after surgery involve the nasolabial fold. The nasolabial folds run from each side of the nose to the corners of the mouth, separating the cheeks from the upper lip. This area has complex contours, unique skin color and texture and the limited availability of mobile adjacent skin. We reconstructed such a defect after Mohs micrographic surgery for basal cell carcinoma of the nasolabial fold area, and we used a subcutaneous island pedicle flap and periosteal suspension suture. Herein we report on the details with the pictures, and we discuss the cosmetic effect and limitations of this method.

Use of Subcutaneous Pedicle Flap in Nasolabial Reconstruction / 대한피부과학회지

BACKGROUND: Surgery of the nasolabial area is susceptible to the distortion of lips, commissure and nasal ala. A subcutaneous pedicle flap is suitable for surgical treatment of mid-size facial defects. OBJECTIVE: To evaluate the effectiveness of a subcutaneous pedicle flap for surgical defects of the nasolabial area. METHOD: We reviewed the medical records and evaluated clinical aspects and surgical treatment outcomes. RESULTS: Total number of patients was 13, including 8 males and 5 females. Mean age was 67.7years-old. Surgical defects were present on the alar crease in 9 cases, and upper lip in 4 cases. Mean size of defects was 1.6 by 1.3 cm. Flaps were well adopted, and no surgical scars were visible. No distortion of the adjacent structures were left. However, the alar crease was slightly blunted in one patient. CONCLUSION: A subcutaneous pedicle flap is suitable for reconstruction of nasolabial area defects.