Effect Of Local Skin Flaps In Repairing Skin And Soft Tissue Defects After Resection Of Head And Facial Lesions

The head and face are important exposed parts of the human body.Their requirements of aesthetic are very high.The aesthetics of the parts and the speciality of functional recovery determine that the repair of skin soft tissue defects is more important than other parts of the body.The reasons of skin soft tissue defects are common in tumors,trauma,congenital or infection.Common skin benign tumors(such as pigmented nevus)and common skin malignancies(such as squamous cell carcinoma(SCC),basal cell carcinoma(BCC),etc.)occur in the head and face.Surgical resection is the primary choice for addressing these conditions.How the wound repair after resection can restore the appearance and function to the greatest extent is a major concern for plastic surgeons.Objective To summarize the clinical effects of various local flaps that repair skin and soft tissue defects of the head and face,and to provide a reference for clinical diagnosis and treatment by observing the long-term recovery effect after repair.Methods Collecting 153 patients who underwent surgical treatment of head and face lesions at the Medical and Aesthetic Center of Qingdao University Hospital from June 2016 to April 2018,and who used local flaps to repair skin and soft tissue defects after the resection.There were 72 males and 83 females with average age of40.5 years old(ranged from 2 to 86 years old).After the preoperative examination,the local lesions were surgically removed,the corresponding local flap was used for stage I repair according to the location and size of the lesion.The dressing was changed on the first day and the next day after surgery,and the suture was removed7-10 days after the operation.The patients were followed up for 6 months to 1year.The length of the incision、the survival of the flaps、the condition of scar and abnormality were observed after operation and the patients’ satisfaction for the repair was obtained through follow-up.Results Among these 153 patients,wound healing by first intention was observed in 146 cases;darkness and necrosis in the distal part of the flap was observed in 6 cases which healed after dressing change;pyogenic infection due to flap incision was observed in one case whose would was closed by skin graft in the second stage.Postoperative follow-up showed that the shape of the affected area was good.All patients were followed up for 6 months to 1 year.Except for 7 patients who were lost to follow-up,the remaining 139 patients had no significant difference in color between the flaps and the surrounding skin.The incision line was notobvious,the scar of the incision was relatively concealed,and there was no tractive deformity in the eyebrows,eyelids,nose and mouth.The patients’ satisfaction was higher.7 patients were unsatisfied with the recovery because of the small incision line and the slight scar on the location.Conclusion The application of local flaps for cosmetic repair of skin and soft tissue defects in the head and face can obtain good therapeutic effects and aesthetics,The postoperative recovery is good and the patients’ satisfaction is high,which is worthy of clinical application.