Reconstruction of the tissue defects after excision of skin malignancies in the head and face region

Objective To investigate the clinical experiences of reconstruction of the tissue defects after resection of skin cancers in the head and face region. Methods From January 1991 to January 2006, 56 patients with skin malignancies in the head and face region were treated with different surgical techniques. According to the characteristics of the patients, the tissue defects were repaired with primary closure in 12 cases, free skin grafting in 8 cases, local skin flap in 25 cases, ortho-position skin flap in 9 cases, and distant skin flap in 2 cases. Results Among 56 cases, 55 skin flaps and skin graftings survived and incision healed by first intention; 1 flap necrosed at the epidermis of the distal end and healed by secondary intention after dressing changes. All of the donor sites healed by first intention. 38 patients were followed up for 1 to 6 years. Among these cases with follow up, 1 case of squamous cell carcinoma with skin grafting occurred recurrence after 1 year respectively and was given radical resection and was reconstructed with skin flap again,the other cases occurred no recurrence. All of patients with follow up survived well. The functional and aesthetic results are satisfactory. Conclusion The skin malignancies in the head and face region should be diagnosised and treated as early as possible. Radical resection, resistance recurrence and simultaneous reconstruction with the satisfactory functional and aesthetic results are crucial for the reconstructive surgeon and are key points of surgical treatments. Based on the aesthetic unit or subunit principles in the head and face region and according to the characteristics of the patients, selection of the reconstructive method must comply with the algorithm from simple to complex. Achievement of the functional and aesthetic outcome should be considered, if possible.