Kosmetische Medizin 3-2009: 92 – 96

Flaps and grafts: Deciding which to use

MIHAELA LEVENTER, CATALIN MIHAI POPESCU, KONSTANTINOS KOUTSIOUKIS, ANA MARIA DUMITRESCU, CLAUDIA CIOBANU, DIANA PLACINTESCU

KEYWORDS: Flaps, Grafts, Reconstructive Scale, Dermatologic Surgery

SUMMARY:
The closure of cutaneous defects after tumor resection comprises of a large variety of reconstructive solutions in order to preserve or restore anatomical functions in association with a good aesthetic outcome. The final decision about the reconstructive choice depends on the technical difficulty, operative morbidity and final result from a functional and aesthetic point of view. At this point, there are many reconstructive algorithms that depend on the dimension and location of skin defects, the surgeon’s technical ability and the oncologic principles. Grafts and flaps represent the most frequently used closure options having a special place in dermatologic surgery and specifical criteria have been proposed for their application. Today, it is well known the superiority of the flaps over grafts because they have optimal postoperative results both in terms of functional and aesthetic. On the other hand, the grafts allow early detection of any recurrence and should be used in situations where the tumor has an aggressive nature and high risk of relapse or in extensive wounds where the flaps tends to be prone for tissue ischemia and necrosis. Finally, flaps have significant value in dermatological surgery, but this should not lead to flapsophilie or graftophobie.