By Desiree S. Ratner, Joel L. Cohen MD, David Brodland
"Facial wound reconstruction following dermatologic surgical procedure for melanoma excision, or different reason behind disfigurement, is without doubt one of the extra difficult approaches a dermatologist can perform. not just does the wound have to be clinically sound, the cultured necessities from sufferers are excessive, and the nostril and surrounding parts are specially challenging.This publication, in line with step by step case experiences released in Dermatologic surgical procedure (the magazine of the yankee Society of Dermatologic Surgery), will introduce the foundations of reconstruction and a number 'how to' ways for nasal reconstructive surgical procedure protecting the alternative of graft for the location after which the surgical method essential to in achieving optimum success.Each case will supply a dialogue of the actual reconstruction wanted, the potential demanding situations, the answer selected and an illustrated 'how to' description of the procedure"--Provided by means of publisher. Read more...
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Extra resources for Reconstructive conundrums in dermatologic surgery : the nose
7 Koranda FC, Webster RC. Trapdoor effect in nasolabial flaps. Causes and corrections. Arch Otolaryngol 1985;111:421–4. 8 Field LM. Peripheral tissue undermining is not the final answer to prevent trapdooring in transposition flaps. J Dermatol Surg Oncol 1993;19:1131–2. CONUNDRUM 5 Dual Nasal Sidewall and Lip Defects Combined into a Single Arcuate Advancement Flap 29 Commentary on conundrum 5 It is not uncommon for patients with skin cancer to have metachronous malignancies, sometimes in close proximity to one another.
Suspension sutures help to relieve tension on the suture line of the distal flap, and to maintain the nasofacial sulcus. 3 An absorbable suture such as 3-0 and 4-0 Dexon suture was used, avoiding vascular compromise of the flap. Burow’s triangles of redundant skin in temple and nasolabial fold, caused by tissue advancement placed into appropriate relaxed skin tension lines, were excised. At the nasal cheek junctions, suspension sutures can adequately reconstitute the nasofacial sulcus obliterated by the movement of the tissue.
Figure 3 Isolation of the flap. 2 In this case, because the traditional ipsilateral NLF was not available for reconstruction of the defect, we resorted to the contralateral region. After adequate hemostasis, the superiorly based right NLF was created (Figure 3). The inferior border of the flap was the right nasolabial crease. 5 cm. The flap was incised through the skin, with the distal end elevated in the subcutaneous plane above the facial musculature. 5 cm wide and was located between the defect and the lower eyelid.