xRead - Facial Reconstruction Following Mohs Micrographic Surgery

The Journal of Craniofacial Surgery Volume 30, Number 2, March 2019

Johnson et al

TABLE 5. Summary of Cheek Study Characteristics Study Study Design Total Patients, n Defect Location Defect Size Reconstructive Technique Complications Follow-up Period Inclusion of PROM Becker et al (1998) 13 RR 132 Cheek 5.87 cm 2 (mean) Secondary intention Wound retraction Persistent ectropion Poor scar cosmesis 2.8 y (mean) No Rustad et al (1998) 14 RR 109 Melolabial crease 3.50 cm 2 (mean) Subcutaneous pedicle flap Secondary debulking procedures (required for 1/3 of flaps > 4 cm 2 ) NS No Fader et al (2002) 15 RR 14 Middle cheek 5.46 cm 2 (mean) Z -plasty transposition flap Superficial tip necrosis (n ¼ 1) Revision surgery (n ¼ 1) NS No Austen et al (2009) 16 RR 32 Cheek 41.76 cm 2 (mean) CFA Flap necrosis (n ¼ 3) Persistent ectropion (n ¼ 1) Hematoma (n ¼ 2) NS No Soliman et al (2010) 17 RR 186 Cheek 4 cm (maximum diameter) Direct linear closure None reported 3 y (mean) No NS No

NS No

Lewin et al (2015) 19 CS 20 Medial/Infraorbital Cheek 4.68 cm 2 (mean) Inferiorly-based rotation flap None reported 2 mo-2 y (range) No VanOnna et al (2016) 20 RR 41 Infraorbital/Zygomatic Cheek 8.00 cm 2 (mean) CFA Early: (1-wk post-op) Ectropion (n ¼ 3) Hematoma (n ¼ 2) Late: (6–8 wks post-op) Sensory neuropathy (n ¼ 17) Color mismatch (n ¼ 12) Numbness (n ¼ 11) Contracture/tension (n ¼ 11) 1 y (minimum) Yes

Wound healing difficulty (n ¼ 7) CFA:(n ¼ 4), PCAF:(n ¼ 1), Linear closure: (n ¼ 1), FTSG: (n ¼ 1) Ectropion (n ¼ 7) CFA (n ¼ 5), Free flap (n ¼ 2)

Flap necrosis (n ¼ 24) SC Ectropion

Flap necrosis (n ¼ 2) CFA:(n ¼ 2)

(n ¼ 3) SC Hypertrophic scarring (n ¼ 2) SC

dissection plane (22%)

Linear closure (53%) CFA (19%) PCAF (8%) FTSG (8%)

V-Y advancement flap (2%) Free flap (1%) Other (9%)

Rapstine et al (2012) 11 RR 400 Cheek < 2 cm 2 (36%) 2–4 cm 2 (20%) 4–6 cm 2 (10%) 6–8 cm 2 (8%) 8–10 cm 2 (6%) > 10 cm 2 (20%)

Jacono et al (2014) 18 RR 88 Cheek 14.30 cm 2 (mean) CFA-SC plane (78%) CFA-deep

CFA, cervicofacial advancement flap; CS, case series; FTSG, full-thickness skin graft; NS, not stated; PCAF, perialar crescenteric advancement flap; PROM, patient-reported outcome measure; RR, retrospective review; SC, subcutaneous plane dissection was used.

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# 2018 Mutaz B. Habal, MD

Copyright © 2019 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.