[Possibilities of reconstruction by de-epithelization (author's transl)]

By definition de-epithelization is a technique by which a graft or a flap is thinned out of the split thickness or full thickness skin layer. The underlying fat tissue is thus covered more or less by corium only. The indications for this procedure are as follows: 1. A subcutaneous defect. 2. Resurfacing defects in a cavity (for example in the pharynx) 3. Subcutaneous implantation of a flap pedicle. The advantages of de-epithelization are: 1. Widening the scope of surgical technique. 2. In many cases second surgery can be avoided. 3. The way from the donor to the recipient site is shorter. 4. A large regional flap can be used not only for reconstruction of the superficial defect but also for subcutaneous filling of a hole. Possible complications are disturbances in the nutrition of the flap and formation of subcutaneous cysts and fistulas which may lead to infections. It is obvious that careful assessment of the indication and precise technique performance are mandatory. Out of 221 flap procedures done in our department since February 1979 we used the de-epithelization technique in 7 cases (3.2%).