Reconstruction of the medial canthus: full-thickness skin graft or local flap?

Abstract

Forty-nine patients with skin tumors in the medial canthal area were operated on from 1986 to 1992. Forty-one of 43 surviving patients (95%) could be re-examined with an average follow-up of two years. In 20 patients, a full-thickness skin graft was used for the immediate reconstruction, in 21 patients a local flap, and in a further 8 patients, both methods were used in combination for the surgical repair. The histology of the lesions was mainly basal cell carcinoma; these may show aggressive extension in the medial canthal region. With the high accuracy intraoperative frozen section, immediate reconstructive surgery was performed after surgical excision. The results of the medial canthal reconstruction, using local flaps or full-thickness skin grafts, were compared in terms of the final functional and cosmetic result. The size and depth of the defect after eradication of the tumor was taken into consideration.