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Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients

Background: Non-melanoma skin cancer (NMSC) takes up a substantial fraction of dermatological and plastic surgical outpatient visits and surgeries. NMSC develops as an accumulated exposure to UV light with the face most frequently diagnosed. Method: This retrospective study investigated the risk of...

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Autores principales: Mamsen, Frederik Penzien Wainer, Kiilerich, Claes Hannibal, Hesselfeldt-Nielsen, Jørgen, Saltvig, Iselin, Remvig, Celine Lund-Nielsen, Trøstrup, Hannah, Schmidt, Volker-Jürgen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781009/
https://www.ncbi.nlm.nih.gov/pubmed/36556287
http://dx.doi.org/10.3390/jpm12122067
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author Mamsen, Frederik Penzien Wainer
Kiilerich, Claes Hannibal
Hesselfeldt-Nielsen, Jørgen
Saltvig, Iselin
Remvig, Celine Lund-Nielsen
Trøstrup, Hannah
Schmidt, Volker-Jürgen
author_facet Mamsen, Frederik Penzien Wainer
Kiilerich, Claes Hannibal
Hesselfeldt-Nielsen, Jørgen
Saltvig, Iselin
Remvig, Celine Lund-Nielsen
Trøstrup, Hannah
Schmidt, Volker-Jürgen
author_sort Mamsen, Frederik Penzien Wainer
collection PubMed
description Background: Non-melanoma skin cancer (NMSC) takes up a substantial fraction of dermatological and plastic surgical outpatient visits and surgeries. NMSC develops as an accumulated exposure to UV light with the face most frequently diagnosed. Method: This retrospective study investigated the risk of complications in relation to full-thickness skin grafts (FTSG) or local flaps in 607 patients who underwent facial surgery and reconstruction at a high-volume center for facial cancer surgery at a tertiary university hospital. Results: Between 01.12.2017 and 30.11.2020, 304 patients received reconstructive flap surgery and 303 received FTSG following skin cancer removal in the face. Flap reconstruction was predominantly performed in the nasal region (78%, n = 237), whereas FTSG reconstruction was performed in the nasal (41,6%, n = 126), frontal (19.8%, n = 60), and temporal areas (19.8%, n = 60), respectively. Patients undergoing FTSGs had a significantly higher risk of hematoma (p = 0.003), partial necroses (p < 0.001), and total necroses (p < 0.001) compared to flap reconstruction. Age and sex increased the risk of major complications (hematoma, partial or total necrosis, wound dehiscence, or infection) for FTSG, revealing that men exhibited 3.72 times increased risk of major complications compared to women reconstructed with FTSG. A tumor size above 15 mm increased the risk of hematoma and necrosis significantly. In summary, local flaps for facial reconstruction after skin cancer provide lower complication rate compared with FTSGs, especially in elderly and/or male patients. The indication for FTSG should be considered critically if the patient’s tumor size and location allow for both procedures.
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spelling pubmed-97810092022-12-24 Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients Mamsen, Frederik Penzien Wainer Kiilerich, Claes Hannibal Hesselfeldt-Nielsen, Jørgen Saltvig, Iselin Remvig, Celine Lund-Nielsen Trøstrup, Hannah Schmidt, Volker-Jürgen J Pers Med Article Background: Non-melanoma skin cancer (NMSC) takes up a substantial fraction of dermatological and plastic surgical outpatient visits and surgeries. NMSC develops as an accumulated exposure to UV light with the face most frequently diagnosed. Method: This retrospective study investigated the risk of complications in relation to full-thickness skin grafts (FTSG) or local flaps in 607 patients who underwent facial surgery and reconstruction at a high-volume center for facial cancer surgery at a tertiary university hospital. Results: Between 01.12.2017 and 30.11.2020, 304 patients received reconstructive flap surgery and 303 received FTSG following skin cancer removal in the face. Flap reconstruction was predominantly performed in the nasal region (78%, n = 237), whereas FTSG reconstruction was performed in the nasal (41,6%, n = 126), frontal (19.8%, n = 60), and temporal areas (19.8%, n = 60), respectively. Patients undergoing FTSGs had a significantly higher risk of hematoma (p = 0.003), partial necroses (p < 0.001), and total necroses (p < 0.001) compared to flap reconstruction. Age and sex increased the risk of major complications (hematoma, partial or total necrosis, wound dehiscence, or infection) for FTSG, revealing that men exhibited 3.72 times increased risk of major complications compared to women reconstructed with FTSG. A tumor size above 15 mm increased the risk of hematoma and necrosis significantly. In summary, local flaps for facial reconstruction after skin cancer provide lower complication rate compared with FTSGs, especially in elderly and/or male patients. The indication for FTSG should be considered critically if the patient’s tumor size and location allow for both procedures. MDPI 2022-12-15 /pmc/articles/PMC9781009/ /pubmed/36556287 http://dx.doi.org/10.3390/jpm12122067 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mamsen, Frederik Penzien Wainer
Kiilerich, Claes Hannibal
Hesselfeldt-Nielsen, Jørgen
Saltvig, Iselin
Remvig, Celine Lund-Nielsen
Trøstrup, Hannah
Schmidt, Volker-Jürgen
Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title_full Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title_fullStr Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title_full_unstemmed Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title_short Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients
title_sort risk stratification of local flaps and skin grafting in skin cancer-related facial reconstruction: a retrospective single-center study of 607 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781009/
https://www.ncbi.nlm.nih.gov/pubmed/36556287
http://dx.doi.org/10.3390/jpm12122067
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