The bilobed flap in skin cancer of the face: Our experience on 285 cases
Received 17 March 2009; accepted 21 October 2009. published online 26 November 2009.
Summary
Background
This article describes how many of the defects caused by oncological surgery can be closed with an easily estended flap.
Patient and Method
The Zitelli bilobed flap was used to treat 285 consecutive patients with basal cell carcinomas (BCCs) or squamous cell carcinomas (SCCs); 167 men (58.60%) and 118 women (41.40%) between 45 and 98 years of age. Histologically, 247 BCCs (86.6%) and 38 SCCs (13.4%) were documented. Regarding the site, 148 (51.9%) involved the nose, 51 (17.9%) the cheeks, 36 (12.6%) the preauricular region, 27 (9.5%) the perilabial region and chin and 23 (8.1%) the periorbital region. To measure long-term satisfaction patients responded to a telephone survey consisting of a single global question.
Results
The size of the defect following tumour removal was between 1 and 4cm. Carcinomas up to 1cm were treated using a one step procedure with a cryostat test of the surgical margins; all others cases were treated using two step procedure after excision and histological in sano resection. Completely acceptable aesthetic and functional deficits were obtained in 275 (96.4%) patients over a 6–72-month follow-up. Ten (3.6%) patients suffered postoperative complications. Two cases of local infection; one case of completely flap necrosis and seven cases of partial revision due to flap necrosis occurred. The level of satisfaction with the surgical long-term result reported by the patients was high.
Conclusion
In our experience the bilobed Zitelli flap for covering defects in the area of the face showed very few complications and good aesthetic results.
1Department of Head and Neck, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100 Modena, Italy
2Department of Maxillo-Facial Surgery, Carlo Poma Hospital, Via Lago Paiolo, 1, 46100 Mantova, Italy
Attilio Carlo Salgarelli, MD, DDS, Prof., Department of Head and Neck, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41100 Modena, Italy. Tel.: +39 5 94223103; Fax: +39 5 937 3428.
ABSTRACT