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- Presentation
Facial Defects: How Would You Close?
Description
In this lecture on closing facial defects, the speaker discusses various techniques for managing wounds, primarily due to skin cancer, which affects one in five Americans. The speaker emphasizes learning from peers and sharing different surgical styles, noting that primary closures are often the most common approach. The procedure involves understanding the importance of cosmetic outcomes, especially near sensitive areas like the lips and nose. Examples of defects treated include squamous cell carcinoma on the lip and forehead, with techniques such as flaps and grafts utilized depending on patient needs. The importance of marking anatomical landmarks, such as the vermilion border, is highlighted, along with tailored closure techniques for elderly patients who may struggle with complex post-operative care. The speaker encourages clear communication with patients regarding potential outcomes and complications, using visual documentation to enhance understanding. Lastly, new techniques like the snug tip stitch are introduced to manage scarring effectively. Overall, the lecture underscores the necessity of adapting surgical techniques to patient characteristics and preferences while striving for optimal aesthetic outcomes.
View moreConclusions
- Skin cancer is a prevalent issue, affecting one in five Americans in their lifetime.
- The majority of surgical closures for skin defects are primary closures, facilitated by careful undermining and layered closure.
- Flaps can be effectively utilized to cover defects, offering advantages such as changing tension direction and camouflaging scars.
- Guiding stitches can aid in maintaining the fullness of the lower lip during partial granulation healing actions.
- Utilizing Novafil sutures is recommended for suturing lips and eyelids due to their ability to accommodate swelling while maintaining wound tension.
- Partial closures can effectively reduce wound size and minimize flap requirements for elderly patients.
- Combination closures involving flaps and grafts can be advantageous for larger defects, especially in delicate areas like the ear.
- Communication with patients about possible outcomes, such as the elevation of the nostril after surgery, is important for reducing anxiety and improving satisfaction.
- Cronin, M, Li, Y, Cronin T. The Snug Tip Stitch: A Tissue Sparing Technique for Correction of Small Dog Ears
- Atlas of Anatomic Reconstruction After Skin Cancer Surgery. Edited by Terrence A. Cronin, Sr and Megan M. Cronin. Springer.