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- Presentation
How Would You Reconstruct This Defect?
Description
The discussion centered around reconstructing a defect caused by squamous cell carcinoma with perineural invasion, particularly after several stages of Mohs surgery. Various reconstruction options were proposed, including tissue expansion, use of biological dressings, and pinch grafts. The speakers highlighted the importance of selecting the right method based on healing conditions, potential radiation therapy, and the location of the defect. Some suggested primary closure along with techniques like bilobed flaps to cover deeper structures. They emphasized the need for granulation and care in managing exposed areas, while others brought up challenges associated with radiation on healing tissues. Ultimately, a mix of techniques was discussed, each with its own merits depending on the specific surface characteristics and healing potential of the patient. The closing remarks celebrated successful outcomes achieved through careful application of these techniques and innovations in wound care.
View moreConclusions
- Simplicity and practicality are crucial in cutaneous reconstruction.
- Clear margins can be achieved after multiple stages of Mohs surgery.
- Perineural invasion significantly complicates surgical planning and might require additional treatments like radiation.
- Various reconstruction strategies should be considered based on the specific defects and patient needs, including tissue expansion, pinch grafts, and biologic dressings.
- Granulation tissue should be encouraged before applying skin grafts to prevent complications.
- Using second intention healing can be effective in certain cases, especially for smaller defects.
- The KISS (Keep It Simple Stupid) principle should guide approaches to complex reconstructions.
- Successful outcomes can result from careful planning and technique, as evidenced by postoperative results without recurrence over two years.