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Skin graft survival on subcutaneous hinge flaps: an algorithm for nasal reconstruction
Robert Almeyda1, Paul van der Eerden, Hade Vuyk
1Department of Otolaryngology, John Radcliffe Hospital, Oxford, United Kingdom.
The Laryngoscope
|January 16, 2013
Summary
This study found that combining subcutaneous soft tissue flaps with skin grafts is effective for nasal reconstruction after skin cancer removal. Perichondrial cutaneous grafts showed higher survival rates than full-thickness skin grafts in this nasal reconstruction method.
Area of Science:
- Plastic Surgery
- Dermatologic Surgery
- Oncology
Background:
- Nasal reconstruction is crucial after basal cell carcinoma excision.
- Subcutaneous soft tissue flaps are utilized to provide a vascularized bed for reconstruction.
- Graft survival is a key determinant of successful nasal reconstruction outcomes.
Purpose of the Study:
- To evaluate the survival rates of full-thickness skin grafts (FTSGs) and perichondrial cutaneous grafts (PCGs).
- To assess graft survival when these grafts are placed on subcutaneous soft tissue flaps.
- To determine the efficacy of this combined approach in nasal reconstruction.
Main Methods:
- A retrospective case series design was employed.
- Data from 28 patients undergoing nasal reconstruction for basal cell carcinoma excision were analyzed.
- Graft survival was correlated with graft type and the specific subcutaneous soft tissue flap used.
Main Results:
- Overall graft survival was 79%.
- Perichondrial cutaneous grafts (PCGs) demonstrated a higher survival rate (89%) compared to full-thickness skin grafts (FTSGs) (74%).
- Procerus and nasalis flaps were anecdotally associated with better graft survival than cheek fat flaps.
Conclusions:
- The combination of subcutaneous soft tissue flaps and skin grafts is a valuable strategy for nasal reconstruction.
- This approach offers a reliable option for patients requiring reconstruction after cutaneous malignancy excision.
- Perichondrial cutaneous grafts may offer superior survival in this reconstructive context.
