Mohs facial reconstructive surgery can be a difficult process for a patient to undergo. The goal of facial reconstruction is to restore contour, function and aesthetics while minimising morbidity. The authors conducted a review of 88 patients who underwent cervicofacial flap reconstruction for Mohs ablative surgery. Patients were categorised into two different groups on the basis of the surgical technique used: subcutaneous (SC) cervicofacial elevation or deep-plane (DP) cervicofacial elevation. Subcategories of smokers and non-smokers within each group were further reviewed. The distal flap survival rates were statistically significant with the DP approach compared with the SC approach. Although mean defect sizes were larger in the DP group (14.3 vs. 12.9cm2), there were no episodes of distal edge necrosis. The authors found better outcomes in smokers treated by the DP approach as well. Although the increase in operative time and technical difficulty may make DP unappealing, the authors advocate this technique due to the merits of significantly less necrosis an excellent choice for dissection of cervicofacial rotation-advancement flaps.

Comparing rates of distal edge necrosis in deep-plane vs. subcutaneous cervicofacial rotation-advancement flaps for facial cutaneous Mohs defect.
Jacono AA, Rousso JJ, Lavin TJ.
Oct 2013; Epub ahead of print.
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Gregor M Bran

Dr Horst Schmidt Kliniken, Wiesbaden, Germany.

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