Super-microdissected local flaps for the coverage of temporal defects.

Abstract

Skin graft is still a method of choice for the coverage of temporal defects. But there are some disadvantages like a "patch" appearance, the need of dressing or longer healing time. Numbers of local flaps have been described for closing skin defects on temporal region. Yet, they may cause distortion of the surrounding tissues, especially in the temporal hairline and eyebrow. We present a series of seven local flaps based on small branches (SB) of the superficial temporal artery (STA) for the coverage of temporal defects, and discuss their advantages. Supermicrodissection of SB of the STA was performed to obtain local flaps for reconstruction of temporal defects after skin cancer excisions in seven patients. Patient's age ranged from 70 to 88 years old and the diameter of defects ranged from 4 to 6 cm. All procedures were performed under local anesthesia except one. In all cases, defects were obtained after skin cancer excisions. The operative time ranged from 55 to 75 min. All flaps survived with an average follow-up of 8 months, reconstructions have maintained a cosmetically pleasing result. We believe that SB flaps may be a new option for reconstruction of temporal defects with the advantages of local flaps, without the inconvenience of a skin pedicle. Moreover, these flaps raise the question of the use of SB based flaps for the coverage of moderate-sized skin defects anywhere in the body, and open new fields in reconstructive surgery.