Irvin Marcel 2016061002

A Comparison of the Local Flap and
Skin Graft by Location of Face in

Reconstruction after Resection of
Facial Skin Cancer
Kyung Suk Lee1,Jun Oh Kim1,Nam
Gyun Kim1,Yoon Jung Lee2,Young Ji
Park1,Jun Sik Kim1
Background
The incidence of facial skin cancer has
increased gradually with changes in the
social and medical environment
Glanz K, Schoenfeld ER, Steffen A. A randomized
trial of tailored skin cancer prevention messages for
adults: project SCAPE
The general predilection site of a skin

facial cancer is the head and neck
Hwang JI, statistical survey of major cutaneous malignant

tumors for the last 10 years (2000~2010, North-east
Gyeonggido Province).
Surgical
excision
Irradiation Electrocautery
CANCER TREATMENT
Curretage Cryotherapy
Secondary
intention
Local and Primary

RECONSTRUCTION
free flaps closure
Skin
grafting
Methods
153 patients
Resection margin
underwent Resection
tumor at 0.5–1 cm for
complete resection
basal cell
and reconstruction
carcinoma,
after excision of
Bowen’s disease,
facial skin cancer
1–2 cm for
from January 2010
squamous cell
to December 2014
carcinoma
; Clinical
information were Local flap or skin
researched such as Dividing faces into graft
patient’s age, sex, 8 area ; compare reconstruction
location, and size patients’
satisfaction with 5
points as the full
score, the
satisfaction
Inclusion and exclusion criteria
Inclusion Exclusion
• Patients underwent • Areas of the face, lips,

complete resection and forehead and chin of
reconstruction after which only the local flap
excision of facial skin was conducted were
cancer from January 2010 excluded from the
to December 2014. satisfaction survey.
Result
Character Local Skin Type Cases (%)
istic flap graft p-value Basal cell carcinoma 87(56.8)
Sex Squamous cell
(male/fem carcinoma 57(37.2)
ale) 31/91 11/20 0.26 Bowen’s disease 9(5.8)
Age (yr) 70.62 67.61 0.18
Diameter Total 153(100)
(cm) 1.93 2.16 0.70
There were 42 men and 111 Basal cell carcinoma was the most
women, age of the patients common type of facial skin cancer,
ranged from 37 years to 95 years, which was found in 87 cases (56.8%),
and the average age was 70 years squamous cell carcinoma was found in
57 cases (37.2%), bowen’s disease was
found in 9 cases (5.8%)
Lower
Method Cheek Nose Temple eyelid Lip Periauricle Forehead Chin Total
Flap 40 41 13 10 5 3 5 2 119
FTSG 9 12 6 2 0 5 0 0 34
Total 49 53 19 12 5 8 5 2 153
• Flap method used in reconstruction, Limberg flap and V-Y

advancement flap were used a lot
• The skin in full thickness skin graft was harvested in the
posterior auricular area (19 cases), and supraclavicular area
(15 cases).
• The follow up period 12 months to 24 months
after surgery
Discussion
The majority of facial skin cancers in this study
were basal cell carcinoma (56.8%) and squamous
cell carcinoma (37.2%).
In this study, the ratio of men to women was

0.37:1 and women were predominant because of
cosmetics use, outdoor living, and increase in
average life of woman.
In this study, flap accounted for the
highest frequency among the methods
because that it can provide a cosmetic
effect.
In this study, the location of the defect were found to be mainly reconstructed
by using Limberg flap / V-Y advancement flap / full thickness skin graft
Comparison of flap and skin graft
Flap Skin graft

(+) it can provide a cosmetic (+) it can easily detect tumor
effect recurrence
(+) flap has a higher survival rate (-) it is difficult to harmonize

as compared to a skin graft with the color and the texture
(-) flap requires an additional (-) it leaves scars of the plate-

incision and movement of tissue like form
• V-Y advancement flap for reconstruction of the lateral upper
lip defect after resection of basal cell carcinoma. (A)
Preoperatively, (B) at 3 days postoperatively, (C) at 1 year
postoperatively.
• Full thickness skin graft for reconstruction of the cheek after
resection of squamous cell carcinoma. (A) Preoperatively, (B)
at 5 days post-operatively, (C) at 6 months postoperatively.
Mean satisfaction for the local flap and
skin graft were 4.3 and 3.5. (p=0.04)
Patient underwent a Patients who
skin graft complained underwent local flap
of the difference in complained of
the texture from the dissatisfaction with
surrounding tissue the length of the scar
Conclusion
the flap is a method that can be preferentially

considered in reconstruction at the location of the
defect after excision of facial skin tumor lesion
Use of a local flap provides an

excellent effect in and cosmetic
satisfaction
Limitation
Number of cases of the local flap was larger

than skin graft
Subjective satisfaction
Uneven reconstruction methods according to

the location of skin tumors

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Irvin Marcel 2016061002

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A Comparison of the Local Flap and

Skin Graft by Location of Face in

The general predilection site of a skin

Hwang JI, statistical survey of major cutaneous malignant

Local and Primary

• Patients underwent • Areas of the face, lips,

• Flap method used in reconstruction, Limberg flap and V-Y

In this study, the ratio of men to women was

Flap Skin graft

(+) flap has a higher survival rate (-) it is difficult to harmonize

(-) flap requires an additional (-) it leaves scars of the plate-

the flap is a method that can be preferentially

Use of a local flap provides an

Number of cases of the local flap was larger

Uneven reconstruction methods according to

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