Update in Cutaneous Reconstruction: Flaps and Skin Grafting

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5998

Special Issue Editors


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Guest Editor
Department of Dermatology, University Clinic of Navarra, 28002 Madrid, Spain
Interests: dermatologic surgery; Mohs surgery; forehead flaps; skin cancer; vascular malformations; congenital melanocytic nevi; cutaneous reconstructive surgery

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Guest Editor
Department of Dermatology, University Clinic of Navarra, School of Medicine, University of Navarra, Pamplona, Spain
Interests: dermatology; skin cancer; dermatological surgery; Mohs surgery; pigmented lesions; dermoscopy; photodynamic therapy
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Special Issue Information

Dear Colleagues,

The incidence of skin cancers is increasing. Non-melanoma skin cancers (NMSCs) comprise common cutaneous malignancies, including basal cell carcinoma and cutaneous squamous cell carcinoma, together with rare cutaneous cancers, such as Merkel cell carcinoma and other forms of adnexal cancers. The majority of NMSCs can be successfully treated with surgery. Local flaps and skin grafts are the most common ways to reconstruct a defect after the removal of skin cancer.

Advances and innovations in dermatologic surgery are outstanding, helping to improve complex and various reconstructions, especially new designs and new indications for local skin flaps. Moreover, dermatologic surgeons not only deal with autologous tissue for reconstructive reasons, but also have expertise in the use of innovative alternative materials, such as dermal substitutes, and regenerative medicine.

In this Special Issue, we welcome authors to submit papers relating to surgical innovations in the field of reconstructive dermatologic surgery, as well as any research that aims to improve the knowledge or techniques in this field. Researchers are encouraged to submit their findings in the form of original articles, reviews, or brief communications.

Dr. Pedro Redondo
Dr. Rafael Salido-Vallejo
Guest Editors

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Keywords

  • skin cancer
  • reconstructive surgery
  • dermatologic surgery
  • local flaps
  • skin grafting
  • dermal substitutes
  • tissue engineering

Published Papers (4 papers)

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Research

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16 pages, 6271 KiB  
Article
Tunneled Island Flaps for the Reconstruction of Nasal Defects: A 21-Case Series
by Fernando Moro-Bolado, Marcos Carmona-Rodríguez, Omar Alwattar-Ceballos, Laura Martínez-Montalvo, María Rogel-Vence, Prado Sánchez-Caminero and Guillermo Romero-Aguilera
J. Clin. Med. 2023, 12(23), 7473; https://doi.org/10.3390/jcm12237473 - 02 Dec 2023
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Abstract
(1) Background: The reconstruction of cutaneous defects following surgical procedures in the nasal pyramid presents a challenge due to the limited amount of available tissue. In cases of larger defects, skin from adjacent units is used. Traditionally, two-stage surgical flaps have been employed [...] Read more.
(1) Background: The reconstruction of cutaneous defects following surgical procedures in the nasal pyramid presents a challenge due to the limited amount of available tissue. In cases of larger defects, skin from adjacent units is used. Traditionally, two-stage surgical flaps have been employed for reconstructing these defects. Tunnelized island flaps allow for the one-stage surgical reconstruction of nasal pyramid defects, using tissue from the forehead or cheek for the flap. (2) Methods: Descriptive retrospective study of 21 consecutive patients who underwent surgery for defects on the nasal pyramid using tunnelized island flaps. (3) Results: Surgical reconstruction was performed in 21 patients with basal cell carcinomas, 14 of them using the melolabial island flap and 7 using the paramedian forehead island flap. In all cases except one, clear histological margins were obtained. Immediate complications were mild and minor. It is worth noting the trapdoor effect complication, which improved over time in most cases, resulting in a satisfactory cosmetic outcome. No tumor recurrences were observed during an average follow-up period of 17.7 months. (4) Conclusions: Tunnelized island flaps allow for single-stage reconstruction of nasal pyramid defects, yielding excellent cosmetic results by utilizing adjacent skin. This procedure demands a certain level of skill but is associated with minimal complications, making it a valuable alternative in reconstructive dermatological surgery. Full article
(This article belongs to the Special Issue Update in Cutaneous Reconstruction: Flaps and Skin Grafting)
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Review

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15 pages, 19416 KiB  
Review
Simplifying Forehead and Temple Reconstruction: A Narrative Review
by Pedro Redondo
J. Clin. Med. 2023, 12(16), 5399; https://doi.org/10.3390/jcm12165399 - 19 Aug 2023
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Abstract
The forehead and temporal region are frequent areas of skin cancer development. After tumor removal, reconstruction must be performed, maintaining the frontal–temporal line of the scalp and symmetry of the eyebrows in an attempt to hide the scars within these marks or natural [...] Read more.
The forehead and temporal region are frequent areas of skin cancer development. After tumor removal, reconstruction must be performed, maintaining the frontal–temporal line of the scalp and symmetry of the eyebrows in an attempt to hide the scars within these marks or natural folds and wrinkles. Second wound healing and skin grafts generally do not produce an acceptable cosmetic result. When direct closure is not possible, the technique of choice is skin flaps. In the midfrontal line continuation of the glabella, there is a remnant of skin to be used as a donor area for local flaps; similarly, it occurs in the preauricular cheek, which can move toward the temple. In addition to the classic advancement and rotation flaps, the frontalis myocutaneous transposition flap is an excellent technique for closing defects which are wider than higher on the forehead. Its design is very versatile and can be performed between the two pupil lines at different heights depending on the location of the defect. On the other hand, the preauricular skin advancement flap with an infralobular Burow’s triangle is also an excellent option for reconstructing tumors in the temporal area. Full article
(This article belongs to the Special Issue Update in Cutaneous Reconstruction: Flaps and Skin Grafting)
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Other

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8 pages, 2219 KiB  
Case Report
A Novel Approach to the Reconstruction of a Large Surgical Defect in the Cheek
by Verónica Ruiz Salas
J. Clin. Med. 2023, 12(24), 7750; https://doi.org/10.3390/jcm12247750 - 18 Dec 2023
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Abstract
Background: Large lateral cheek defects can be challenging to reconstruct. Several approaches to reconstruction of these defects have been reported. In the case presented here, we describe an alternative reconstruction method for this type of surgical defect. Detailed Case Description: We present one [...] Read more.
Background: Large lateral cheek defects can be challenging to reconstruct. Several approaches to reconstruction of these defects have been reported. In the case presented here, we describe an alternative reconstruction method for this type of surgical defect. Detailed Case Description: We present one patient with a large basal cell carcinoma on his lateral left cheek who underwent a complete tumor removal by Mohs surgery and was left with a defect 6 × 6 cm in size. This large defect was closed by performing a double transposition flap under local anesthesia. Results: Both flaps survived with no loss. The immediate and long-term outcomes were satisfactory, preserving functionality with good cosmetic results. Conclusions: Cheek defect reconstruction with the double transposition flap is simple and reliable, with good aesthetic and functional outcomes. It may be considered as an alternative reconstructive method for this type of defect, in an appropriate context. Full article
(This article belongs to the Special Issue Update in Cutaneous Reconstruction: Flaps and Skin Grafting)
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16 pages, 1780 KiB  
Systematic Review
Reconstructive Procedures of the Auricular Concha after Cutaneous Oncologic Surgery: A Systematic Review
by Sofia Moreno-Vazquez, Javier Antoñanzas, Inés Oteiza-Rius, Pedro Redondo and Rafael Salido-Vallejo
J. Clin. Med. 2023, 12(20), 6521; https://doi.org/10.3390/jcm12206521 - 14 Oct 2023
Viewed by 717
Abstract
Reconstruction of the auricular concha poses a challenge due to its difficult access and limited tissue flexibility; however, there are no recommendations in the literature on which reconstructive technique should be favored for this anatomical site. This systematic review intends to describe and [...] Read more.
Reconstruction of the auricular concha poses a challenge due to its difficult access and limited tissue flexibility; however, there are no recommendations in the literature on which reconstructive technique should be favored for this anatomical site. This systematic review intends to describe and compare the reconstructive techniques used in conchal bowl reconstruction following cutaneous oncologic surgery of this region, with regard to their complications and aesthetic results. In doing so, we aim to identify the best suited reconstructive procedure(s) for the conchal bowl. The six databases searched (PubMed, Scopus, Web of Science, Ovid, SciELO, and CENTRAL) yielded twelve eligible studies that explored the revolving door flap, split-thickness skin grafts (STSG), full-thickness skin grafts (FTSG), second intention healing, the preauricular translocation flap, subcutaneous pedicle grafts, and other local flaps. Qualitative synthesis of the results concluded that the revolving door flap could be the reconstructive procedure of choice for the auricular concha, following skin cancer excision. It has a low risk of necrosis, infection, and postoperative hemorrhage, as well as excellent aesthetic outcomes. STSG may be used as an alternative. Nonetheless, due to the low sample size and the high risk of bias in some studies, further investigations must be conducted on this subject. Full article
(This article belongs to the Special Issue Update in Cutaneous Reconstruction: Flaps and Skin Grafting)
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