Transposition flap use to repair failed melolabial interpolated flap post basal cell carcinoma excision of nasal region

Authors

  • Nugrohoaji Dharmawan Sebelas Maret University
  • Irene Irene Ardiani Pramudya Wardhani Sebelas Maret University

Keywords:

transposition flap, nasal defect, basal cell carcinoma, necrosis, melolabial flap

Abstract

Introduction: Reconstruction of postoperative defects in basal cell carcinoma (BCC) in the nasal region is quite challenging. Hematoma, bleeding, infection, partial or total necrosis are complications of the procedure. Case: A 72-year-old woman admitted with a non-healing wound on her nose since a year ago. She had a history of hypertension. On dermatological examination of nasal alar, there was an ulcer measuring 1.6 x 1.7 x 0.1 cm has an uneven surface, irregular edges, erosions, pus, blood and telangiectasia. Dermoscopy and histopathological examination support the picture of nodular BCC. The patient was managed with Mohs microscopic sugery followed by reconstruction of the defect with a melolabial interpolated flap. On the 11th day, necrosis was found on the distal, resulting in a new defect. At week 8, second surgery was performed with a transposition flap. The results of the evaluation at the fourth week showed good wound healing. Discussion: Comorbidities such as hypertension can disrupt vascularization and interferes with flap oxygenation, causing partial necrosis on the distal of the flap. Transposition flap was used to cover the previous flap failure with good results.

References

Dika E, Scarfì F, Ferracin M, et al. Basal cell carcinoma: A comprehensive review. Int J Mol Sci. 2020;21(15):1-11. doi:10.3390/ijms21155572

Lucas JB. The Physiology and Biomechanics of Skin Flaps. Facial Plast Surg Clin North Am. 2017;25(3):303-311. doi:10.1016/j.fsc.2017.03.003

Choi JH, Kim YJ, Kim H, Nam SH, Choi YW. Distribution of basal cell carcinoma and squamous cell carcinoma by facial esthetic unit. Arch Plast Surg. 2013;40(4):387-391. doi:10.5999/aps.2013.40.4.387

Shan R. Baker. Flap classificaton and design . In: Shan R. Baker, ed. Baker Local Flaps in Facial Reconstruction. Vol 1. 3rd ed. Elsevier; 2014:71-107.

Schrey A, Kinnunen I, Vahlberg T, et al. Blood pressure and free flap oxygenation in head and neck cancer patients. Acta Oto-Laryngol. 2011;131(7):757-763. doi:10.3109/00016489.2011.554438

Downloads

Published

2023-08-07

How to Cite

1.
Dharmawan N, Irene Ardiani Pramudya Wardhani I. Transposition flap use to repair failed melolabial interpolated flap post basal cell carcinoma excision of nasal region. J Pak Assoc Dermatol [Internet]. 2023Aug.7 [cited 2024Dec.4];33(3):1185-7. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/2230

Issue

Section

Case Reports