By Desiree S. Ratner, Joel L. Cohen MD, David Brodland
"Facial wound reconstruction following dermatologic surgical procedure for melanoma excision, or different reason for disfigurement, is among the extra difficult systems a dermatologist can perform. not just does the wound must be clinically sound, the cultured requisites from sufferers are excessive, and the nostril and surrounding parts are particularly challenging.This booklet, in keeping with step by step case reports released in Dermatologic Read more...
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Additional resources for Reconstructive conundrums in dermatologic surgery : the nose
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Published 2014 by John Wiley & Sons, Ltd. 25 26 The lip defect posed a more challenging reconstructive dilemma, because the defect had become somewhat semicircular and immediately adjacent to the alar rim after tumor extirpation. Likely the best reconstructive options for this closure would be either an island pedicle advancement or a rotation flap. With the island pedicle flap, incision lines could be partially camouflaged into the melolabial fold. In a rotation flap, a vertical, inferiorly placed Burow’s triangle would act as the pivot, and the arc of the rotation would create an incision line along the melolabial fold.
When using this flap, care must be taken to compensate for rotational shortening by designing it with a wide leading edge lateral arc. Failure to do so can result in disruption of alar symmetry. The choice of a dorsal nasal flap in this case was an excellent one. The fact that this flap is large (something that can be quite scary for patients initially) and continues across the entire dorsum of the nose, however, translates to a good deal of suturing and the possibility of prominent lines along the proximal two-thirds of the nose.
1). In this instance, there was sufficient cheek laxity such that a Burow’s triangle could be removed inferiorly, and the cheek skin advanced medially, thereby placing the suture line within the nasolabial fold. 2). Because adjacent skin tends to have a similar color, thickness, and texture, it tends to provide a cosmetically superior match compared with grafts harvested from more distant locations. 3). 2 Excision of lower Burow’s triangle with closure of medial cheek defect along the nasolabial fold and Burow’s full-thickness skin graft placed within the remaining nasal sidewall defect.