DOI QR코드

DOI QR Code

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

  • Kang, Jae Kyoung (Department of Plastic and Reconstructive Surgery, Jeju National University Hospital) ;
  • Lee, Jae Seong (Department of Plastic and Reconstructive Surgery, Jeju National University Hospital) ;
  • Yun, Byung Min (Department of Plastic and Reconstructive Surgery, Jeju National University School of Medicine) ;
  • Shin, Myoung Soo (Department of Plastic and Reconstructive Surgery, Jeju National University School of Medicine)
  • 투고 : 2020.08.26
  • 심사 : 2020.12.20
  • 발행 : 2020.12.20

초록

Background: Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. Methods: We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. Results: We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. Conclusion: In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient's advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

키워드

참고문헌

  1. Johnson TM, Ratner D, Nelson BR. Soft tissue reconstruction with skin grafting. J Am Acad Dermatol 1992;27(2 Pt 1):151-65. https://doi.org/10.1016/0190-9622(92)70164-B
  2. Dimitropoulos V, Bichakjian CK, Johnson TM. Forehead donor site full-thickness skin graft. Dermatol Surg 2005;31:324-6. https://doi.org/10.1111/j.1524-4725.2005.31082
  3. Rathore DS, Chickadasarahilli S, Crossman R, Mehta P, Ahluwalia HS. Full thickness skin grafts in periocular reconstructions: long-term outcomes. Ophthalmic Plast Reconstr Surg 2014;30:517-20. https://doi.org/10.1097/IOP.0000000000000237
  4. Matheson BK, Mellette JR Jr. Surgical pearl: clavicular grafts are "superior" to supraclavicular grafts. J Am Acad Dermatol 1997;37:991-3. https://doi.org/10.1016/S0190-9622(97)70078-1
  5. Kim S, Choi TH, Liu W, Ogawa R, Suh JS, Mustoe TA. Update on scar management: guidelines for treating Asian patients. Plast Reconstr Surg 2013;132:1580-9. https://doi.org/10.1097/PRS.0b013e3182a8070c
  6. Fearmonti R, Bond J, Erdmann D, Levinson H. A review of scar scales and scar measuring devices. Eplasty 2010;10:e43.
  7. Park YJ, Kwon GH, Kim JO, Ryu WS, Lee KS. Reconstruction of nasal ala and tip following skin cancer resection. Arch Craniofac Surg 2019;20:382-7. https://doi.org/10.7181/acfs.2019.00486
  8. Lau B, Younger RAL. Skin grafts in head and neck reconstruction. Oper Tech Otolayngol Head Neck Surg 2011;22:24-9. https://doi.org/10.1016/j.otot.2010.08.004
  9. Lee Y, Hwang K. Skin thickness of Korean adults. Surg Radiol Anat 2002;24:183-9. https://doi.org/10.1007/s00276-002-0034-5
  10. Ha RY, Nojima K, Adams WP Jr, Brown SA. Analysis of facial skin thickness: defining the relative thickness index. Plast Reconstr Surg 2005;115:1769-73. https://doi.org/10.1097/01.PRS.0000161682.63535.9B
  11. Petruzzelli GJ, Johnson JT. Skin grafts. Otolaryngol Clin North Am 1994;27:25-37. https://doi.org/10.1016/S0030-6665(20)30714-3
  12. Yoo WJ, Lim SY, Pyon JK, Mun GH, Bang SI, Oh KS. Usefulness of full-thickness skin graft from anterolateral chest wall in the reconstruction of facial defects. J Korean Soc Plast Reconstr Surg 2010;37:589-94.
  13. Custer PL, Harvey H. The arm as a skin graft donor site in eyelid reconstruction. Ophthalmic Plast Reconstr Surg 2001;17: 427-30. https://doi.org/10.1097/00002341-200111000-00008
  14. Celikoz B, Deveci M, Duman H, Nsanci M. Recontruction of facial defects and burn scars using large size freehand fullthickness skin graft from lateral thoracic region. Burns 2001; 27:174-8. https://doi.org/10.1016/S0305-4179(00)00085-1
  15. McCluskey PD, Constantine FC, Thornton JF. Lower third nasal reconstruction: when is skin grafting an appropriate option? Plast Reconstr Surg 2009;124:826-35. https://doi.org/10.1097/PRS.0b013e3181b03749
  16. Oh CM, Cho H, Won YJ, Kong HJ, Roh YH, Jeong KH, et al. Nationwide trends in the incidence of melanoma and nonmelanoma skin cancers from 1999 to 2014 in South Korea. Cancer Res Treat 2018;50:729-37. https://doi.org/10.4143/crt.2017.166
  17. Kim YH, Yoon HW, Chung S, Chung YK. Reconstruction of cutaneous defects of the nasal tip and alar by two different methods. Arch Craniofac Surg 2018;19:260-3. https://doi.org/10.7181/acfs.2018.02271
  18. Kim GW, Bae YC, Bae SH, Nam SB, Lee DM. A clinical review of reconstructive techniques for patients with multiple skin cancers on the face. Arch Craniofac Surg 2018;19:194-9. https://doi.org/10.7181/acfs.2018.02012