J Rustemeyer1, A Bremerich. 1. Department of Cranio-Maxillofacial Surgery, Klinikum Bremen Mitte, Bremen, Germany. janrustem@t-online.de
Abstract
BACKGROUND: Missing recurrences and the aesthetic outcomes after reconstructions of the face are preoccupations in the surgical treatment of basal cell carcinomas. Hence, the different reconstructive techniques in particular and the rate of recurrence are evaluated in this study. PATIENTS: 205 patients receiving resections of basal cell carcinomas and facial skin reconstructions were included and data were analyzed. RESULTS: The rate of recurrence was 7.3% after follow-up at an average of 2.5 years (0.5-5 years). Local flaps, full-thickness skin grafts and skin extension closures were carried out most often; indications for split-thickness skin grafts were rare. Sensitivity disturbances occurred in only 3.6% of skin extension closures and in 11.7% of local flaps, but in 22.7% of full-thickness skin grafts and in 38.7% of split-thickness skin grafts. The aesthetic outcomes were evaluated through clinical inspection and by using patients' scale. They were classified as "unobtrusive" and "excellent or good" in 88.4% of local flaps and in 92.6% of skin extension closures, but in only 66.4% of full-thickness skin grafts and in 54% of split-thickness skin grafts. CONCLUSION: Local flaps and skin extension closures provide better aesthetic and neurological outcomes after facial skin reconstructions. However, skin grafts are alternative procedures for critical indications of local flaps.
BACKGROUND: Missing recurrences and the aesthetic outcomes after reconstructions of the face are preoccupations in the surgical treatment of basal cell carcinomas. Hence, the different reconstructive techniques in particular and the rate of recurrence are evaluated in this study. PATIENTS: 205 patients receiving resections of basal cell carcinomas and facial skin reconstructions were included and data were analyzed. RESULTS: The rate of recurrence was 7.3% after follow-up at an average of 2.5 years (0.5-5 years). Local flaps, full-thickness skin grafts and skin extension closures were carried out most often; indications for split-thickness skin grafts were rare. Sensitivity disturbances occurred in only 3.6% of skin extension closures and in 11.7% of local flaps, but in 22.7% of full-thickness skin grafts and in 38.7% of split-thickness skin grafts. The aesthetic outcomes were evaluated through clinical inspection and by using patients' scale. They were classified as "unobtrusive" and "excellent or good" in 88.4% of local flaps and in 92.6% of skin extension closures, but in only 66.4% of full-thickness skin grafts and in 54% of split-thickness skin grafts. CONCLUSION: Local flaps and skin extension closures provide better aesthetic and neurological outcomes after facial skin reconstructions. However, skin grafts are alternative procedures for critical indications of local flaps.