Full thickness skin grafts for temporary and for potential definitive closures of defects in the context of the microscopic-controlled surgery for the removal of malignant facial skin tumours

摘要

A tumour-cell free margin (R0 resection) is the most important prognostic factor for the success of the treatment of malignant facial skin tumours. Its evaluation is possible with high reliability by the methods of microscopic-controlled surgery, but only by means of definitive formalinfixed histological slices, especially for the lateral tumour borders.1 In the actual guidelines a subsequent delayed defect reconstruction is recommended, as soon as we are certain that all the borders are free of tumour cells. The subsequent reconstruction follows in a second stage operation.2 It is a long procedure which puts the patient under great strain. To avoid these disadvantages for the patients we immediately reconstructed middle-sized defects by free full thickness skin grafts. This permits a simple revision in case of a R1- resection. If the aesthetic result is satisfying this will be the definitive reconstruction, if not a correction by means of local flaps can be made in a time of choice.