Surgical management of nonmelanomatous malignant cutaneous lesions of the face

Abstract

Objective The aim of the present study was to evaluate the esthetic and functional outcomes after surgical excision of nonmelanomatous malignant lesions of the face, followed by a suitable tool of reconstruction. Background Neoplasm of the skin is found most often on the face. Cosmetically, the face is the most important anatomic area for most patients. Because of this, malignant tumors of the facial skin pose a great challenge in treatment, prohibiting compromises between oncologically responsible surgery and functional and cosmetic outcomes. Patients and methods This prospective study included 25 patients, all of them suffering from nonmelanomatous skin cancer and managed at Menoufia University Hospitals and Damanhur Oncology Center by different modalities of reconstruction during the period from April 2012 to December 2014. The appropriate technique was selected for every patient, taking in consideration the location and size of the lesion. Results Eighteen cases had reconstructive procedures with local flaps only, five cases had more combined reconstructive tools in the form of local flaps (rotational flaps) plus split-thickness graft to close the secondary defect, and two cases required reconstruction with a full-thickness graft. Conclusion Our experience showed that the postoperative defects gave the best cosmetic results when reconstructed by using a nearby tissue, fulfilling all patient and surgeon expectations with a minimum rate of morbidity. Clear guidelines and a multidisciplinary approach for the treatment of skin cancer are important to ensure that patients receive optimal care with satisfactory end results for tumor control as well as reconstructive esthetic outcome.