The Application Of Local Skin Flap In The Repair Of Wounds After Resection Of Facial Basal Cell Carcinoma

Objective:Research the clinical retrospective of 24 cases of facial basal cell carcinoma(BCC),and summarized the methods that the local flaps which designed according to the aesthetic subunit and aesthetic principles of the lesions repaired the skin and soft tissue defects,and then observed its’ clinical application in the wound repair after the resection of BCC.Methods:Collected 24 patients who underwent surgical treatment with facial basal cell carcinoma at First Affiliated Hospital of Kunming Medical University from September 2017 to September 2019.There were 14 males and 10 females with average age was(52.34 ± 12.63)years old.Lesions location:3 cases of frontotemporal region,5 cases of orbital region,8 cases of cheek region and 8 cases of nose region.the size of defects to be repaired was 5 × 5mm～50 × 10 mm.After the tumors were surgically removed,the corresponding local flaps which designed according to the aesthetic subunit and aesthetic principles were transfered and repaired the skin and soft defects.The local flaps used to repair the defects included 7 cases of advancement flap(2 cases of V-Y advancement flap,3 cases of kite flap,2 cases of adjacent gliding flap),4 cases of rotation flap,12 cases of transposition flap(2 cases of classic transposition flap,9 cases of diamond flap,1 case of nasolabial groove flap)and 1 case of combined use of multiple local flaps.The dressing was changed on the first day and the suture was removed on 5～7 days,the follow-up was 6 months to 1 year.Compared the patients’ mental state before and after repair(anxiety,depression)scores,recovery effect of flaps(evaluation of Aesthetic and function)and the quality of life.Results:24 cases were all healed in stageI.After 6 to 12 months followed-up,the patients’ SAS scores and SDS scores were significantly lower than those before operations(P<0.05).The appearance of the operation area matched well with the surrounding tissue,the scar hyperplasia was light,the important organs had no obvious deformity and displacement after repair,the aesthetic degree and function score were significantly higher than that before operation,the difference was statistically significant(P<0.05).The quality of life score of patients after repair was significantly higher than before,the difference was statistically significant(P<0.05).Conclusions:The local flaps were designed according to the aesthetic subunit and aesthetic principle of the face,and then transfered them to repair the wounds after facial tumors resection,it can take the aesthetic effect into account while preserving the function of the organ.The survival rate of the local flap and the satisfaction degree of the patients are high,which is worthy of clinical application.