Principles and Clinical Application of Free-Style Capillary Perforator-Based Flap for Coverage of Facial Skin Cancer Defects

Abstract

Simple Summary: This study introduces a groundbreaking method known as the true free-style capillary perforator flap, revolutionizing the approach to reconstructing facial skin defects, such as skin cancer. By meticulously employing a flap design technique that integrates principles such as finger-pinching and alignment with wrinkle directions, the study demonstrates successful reconstructions across various facial regions, including the infraorbital area, nose, and cheek, with a remarkable reduction in postoperative complications. Its contribution lies not only in its clinical success but also in its potential to improve patients' quality of life by offering a reliable and aesthetically pleasing solution to facial skin defects. The true free-style capillary perforator flap stands poised to become a cornerstone in the management of facial skin defects, paving the way for enhanced patient care and outcomes in the realm of reconstructive surgery. Abstract: This study introduces a free-style perforator based island flap (PBIF) for the reconstruction of skin defects. From March 2012 to December 2022, a retrospective investigation was conducted on patients who underwent reconstruction for facial defects due to skin cancer. Data on the patients' gender, age, anesthesia method, diagnosis, defect location, flap size, complications, and follow-up periods were collected. There are several principles for designing the PBIF: finger-pinching method, alignment with the direction of wrinkles, the smaller width and longer length of the flap, and proximal attachment to the muscle. A total of 32 patients were included, with an average age of 63.6 years. Surgeries were performed in various regions, such as the infraorbital area, nose, cheek, philtrum, and the anterior/posterior/inferior auricular regions, with an average flap size of 7.63 cm2. There were no complications, such as venous congestion or vascular insufficiency in the skin flaps, although one case required revisional closure due to flap disruption. The PBIF is a useful and effective method for the restoration of facial defects. This method can provide simple yet aesthetically satisfying results, showing stable outcomes without complex surgeries or complications. This study indicates the potential for this method to be more widely employed in reconstructive surgeries in the future.