A Large Defect on Nasal Dorsum Treated by Secondary Intention Healing / 대한피부과학회지

ABSTRACT

A 79-year-old man taking warfarin presented with a large defect measuring 3.2×3.4 cm on his nasal dorsum after wide excision of recurrent basal cell carcinoma. A delayed repair was planned; however, uncontrolled oozing and bleeding occurred. The patient’s international normalized ratio (INR) had increased to 4.07 and an immediate intramuscular vitamin K injection was prescribed, which stopped the bleeding and oozing. The patient refused further reconstructive surgery and agreed to covering the defect with secondary intention healing, despite the convexity of the nasal dorsum. Although a depression with mild contracture and hypertrophic scars were left on the wound, the patient was satisfied without any recurrence or infection within 5 months. While secondary intention healing is not a common option for repair in convex areas of large facial defects, it could be an alternative for large nasal dorsum defects.