Indications for facial flaps

Authors: Liv Schöllhammer, MD, Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

Here you will learn about the Indications and contraindications for performing af facial flap.

Indications

• Not possible to reconstruct defect by direct closure
• Secondary healing will leave unintentional scar tissue with impact on physical appearance 
• Skin graft is not possible or will have an impact on physical appearance with non-matching color, strictures or drag in nose, lip or eyelid.
• The donor site can be closed directly without larger physical impact.
• The reconstructive flap is reliable by the surgeon
• Replace excised defect with alike: The flap is same skin-color and skin-texture as the defect.

Contraindications

• Direct closure will have an expected good result.
• The skin carcinoma should be treated using radiotherapy instead of surgery (i.e. on the tip of the nose).
• A larger defect should be reconstructed with a distant flap (i.e,. infiltrating tumor into oral cavity).
• Poor patient health – Patients in ASA group 3 or 4, with severe insulin-dependent diabetes mellitus and heavy smokers often have an increased risk of complications.