H M Gloster1. 1. Department of Dermatology, University of Cincinnati, Ohio, USA.
Abstract
BACKGROUND: Full-thickness skin grafts are traditionally thought of as inferior alternatives to local flaps in nasal reconstruction. OBJECTIVE: Our purpose was to demonstrate that full-thickness skin grafts are viable alternatives to local flaps in the reconstruction of nonperforating defects extending through the dermis of the nose. METHODS: The literature was reviewed to determine the best donor sites for full-thickness skin grafts to repair defects on different regions of the nose. RESULTS: The optimal donor site for the repair of defects on the thin skin of the upper two thirds of the nose (dorsum and sidewall) is the preauricular area. The best donor site for the repair of defects on the thick, sebaceous skin of the lower one third of the nose (tip and ala) is the conchal bowl of the ear. Defects located on the transition zone between the upper two thirds and lower one third of the nose are best repaired with Burow's grafts or nasolabial fold grafts. CONCLUSION: Full-thickness skin grafts are excellent alternatives to local flaps in the reconstruction of nonperforating nasal defects provided that the surgeon selects the appropriate donor site based on whether the surgical defect is located on the thin, pliable skin of the upper nose or the thick, sebaceous skin of the lower nose.
BACKGROUND: Full-thickness skin grafts are traditionally thought of as inferior alternatives to local flaps in nasal reconstruction. OBJECTIVE: Our purpose was to demonstrate that full-thickness skin grafts are viable alternatives to local flaps in the reconstruction of nonperforating defects extending through the dermis of the nose. METHODS: The literature was reviewed to determine the best donor sites for full-thickness skin grafts to repair defects on different regions of the nose. RESULTS: The optimal donor site for the repair of defects on the thin skin of the upper two thirds of the nose (dorsum and sidewall) is the preauricular area. The best donor site for the repair of defects on the thick, sebaceous skin of the lower one third of the nose (tip and ala) is the conchal bowl of the ear. Defects located on the transition zone between the upper two thirds and lower one third of the nose are best repaired with Burow's grafts or nasolabial fold grafts. CONCLUSION: Full-thickness skin grafts are excellent alternatives to local flaps in the reconstruction of nonperforating nasal defects provided that the surgeon selects the appropriate donor site based on whether the surgical defect is located on the thin, pliable skin of the upper nose or the thick, sebaceous skin of the lower nose.