DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20212806

Cervico-facial flap: a versatile option among various reconstructive options for skin defects in parotid surgery-our experience in a tertiary care center

Amritha Prabha, Garima Sarawgi, Urvish Shah, Ganesh M. S., Abhinay Reddy, B. R. Keerthi, Hemanth G. N., Rahul Surapaneni, Khyati Melanta, Udayee Teja Bathala

Abstract


Background: Cutaneous defects of the cheek and external ear present a reconstructive challenge. Even when free flap reconstructions and tissue transfer are commonly proposed, fewer patients with these malignancies are candidates for lengthy reconstructive surgery. The cost effectiveness, time consumption, long waiting period of head and neck malignancy patients and less availability of reconstruction teams in developing countries like India, are challenging factors.

Methods: In our study, retrospectively 46 cases operated for parotid neoplasm were identified and the operative reports were reviewed from September 2018 to April 2021. Data on patient demographics, pathological diagnosis, defect type, type of flap used, co-morbid disease, and smoking history was collected.  

Results: The mean defect size was 4×5 cm, however for defects larger than 4×4 cm and lesser than 7 cm a cervico-facial flap was used for reconstruction. The average time for surgery was 2 and a half hours extra for the free flap reconstruction. Post-operative wound complications were higher in free flap reconstruction. Partial/DTN was observed in 16% patients and necrosis that needed intervention- 6% of all patients. Patients with cervico-facial flap reconstruction had an excellent final functional and cosmetic result, with good skin color and texture match.

Conclusions: The cervico-facial flap is a versatile technique with excellent vascularity and good esthetic outcome, which should be utilized liberally in the reconstruction of facial defects, slight modifications in the flap harvesting and careful selection of patient can give excellent results in moderate defects after parotid surgeries, especially in a resource limited country like India.


Keywords


Cervico-facial flap, Facial defect reconstruction, Parotid surgeries, Superficial and distal flap necrosis

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References


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