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Reconstruction of midface defects using local flaps An algorithm for appropriate flap choice

Title
Reconstruction of midface defects using local flaps An algorithm for appropriate flap choice
Author
이장현
Keywords
advancement flap; algorithm; midface defect; transposition flap
Issue Date
2019-11
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
MEDICINE, v. 98, no. 46, article no. e18021
Abstract
Background: Local flap surgery is commonly performed to cover defects with appropriate skin color and texture match. The purpose of this study was to present an algorithm for choosing an appropriate flap when reconstructing a midface defect using a local flap. Methods: Between February 2013 and February 2019, 38 patients with midface defects underwent local flap surgery. All defects larger than 3cm in diameter were reconstructed with perforator-based transposition flaps. Defects smaller than 3cm in diameter were reconstructed differently depending on their location. Defects near the nasolabial fold (NLF) were reconstructed with perforator-based transposition flaps, whereas defects just on the NLF were reconstructed with VY advancement flaps. Defects distant from the NLF were also reconstructed with VY advancement flaps. Results: Perforator-based transposition flaps were used in 22 cases and VY advancement flaps were used in 16 cases according to our new algorithm. All flaps survived without any complications. The aesthetic results were superior for VY advancement flaps, with higher patient satisfaction scores. The skin color match was similar for both flaps, but the contour was more natural in advancement flaps than in transposition flaps. However, transposition flaps had the benefits of being able to cover relatively large defects and allowing the donor scar to be hidden in a wrinkle line. Conclusion: The most suitable local flap for coverage of a midface defect can be chosen based on the patient's condition. By following our algorithm, appropriate reconstructions can be performed, with satisfactory results.
URI
https://journals.lww.com/md-journal/Fulltext/2019/11150/Reconstruction_of_midface_defects_using_local.79.aspxhttps://repository.hanyang.ac.kr/handle/20.500.11754/155198
ISSN
0025-7974; 1536-5964
DOI
10.1097/MD.0000000000018021
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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