Use of local-regional flaps in facial reconstruction

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.