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Uneasy (Intractable) Head and Neck Defect Coverage With Easy and Reliable Local Flap Techniques: A Retrospective
Chi Sun Yoon1, Wooseob Kim2, Eun A Jang2
1Department of Plastic and Reconstructive Surgery Gangneung Asan Hospital, University of Ulsan College of Medicine Gangneung Korea.
Objectives:
Head and neck defects are challenging to reconstruct. Local flaps, preserving donor sites, offer optimal results. This study evaluated perforator-plus peninsular flaps (PPPF) and modified keystone flaps (MKF) for reconstructing "uneasy" defects lacking clear solutions.
Methods:
Records of patients undergoing PPPF or MKF were reviewed. Defects were defined as "uneasy" if two of three experienced plastic surgeons could not suggest a local flap within 10 min. Data on demographics, defect features, flap type, complications, and Patient and Observer Scar Assessment Scale (POSAS)-based scar outcomes were analyzed.
Results:
Ten patients (mean age, 50.3 years) were included. Defects involved the scalp and forehead (60%), ear (20%), cheek (10%), and neck (10%) with a mean size of 16.5 cm2. All flaps (PPPF 40%, MKF 60%) survived without complications. Mean POSAS scores were 15.1 (patient) and 18.3 (observer).
Conclusion:
PPPF and MKF offer reliable solutions for uneasy head and neck defects.
