Local and Advancement Flaps for Facial Reconstruction

GENERAL CONSIDERATIONS

Wounds caused by removal of large tumors from the facial region frequently require some form of reconstructive surgery. Although most defects can be repaired using local available tissues, reconstructions can be very challenging, even in the hands of experienced surgeons.Techniques for wound reconstruction include local flaps, indirect flaps, axial pattern flaps, or free skin grafts. The type of technique that will be utilized depends on the availability of local skin, size of wound created, and the location of the wound. Because of the paucity of skin available and because of the 2 eyes openings, techniques most commonly used on the trunk (as the double monopedicular flap) may not be used on the face. In trauma cases, local flaps usually provide enough tissue to cover even relatively large defects. In oncologic patients, the goal of the operative plan is a curative resection or a palliation. In these cases, regional axial pattern flaps may serve as a compromise between local flaps and grafts. The availability of cervical and frontal cutaneous flaps with direct cutaneous blood supply for head and neck reconstruction may allow radical resection avoiding functional disturbances while providing a cosmetic result. […]