The bilobed flap in skin cancer of the face: our experience on 285 cases.

Abstract

BACKGROUND: This article describes how many of the defects caused by oncological surgery can be closed with an easily estended flap. PATIENT AND METHOD: The Zitelli bilobed flap was used to treat 285 consecutive patients with basal cell carcinomas (BCCs) or squamous cell carcinomas (SCCs); 167 men (58.60\%) and 118 women (41.40\%) between 45 and 98 years of age. Histologically, 247 BCCs (86.6\%) and 38 SCCs (13.4\%) were documented. Regarding the site, 148 (51.9\%) involved the nose, 51 (17.9\%) the cheeks, 36 (12.6\%) the preauricular region, 27 (9.5\%) the perilabial region and chin and 23 (8.1\%) the periorbital region. To measure long-term satisfaction patients responded to a telephone survey consisting of a single global question. RESULTS: The size of the defect following tumour removal was between 1 and 4cm. Carcinomas up to 1cm were treated using a one step procedure with a cryostat test of the surgical margins; all others cases were treated using two step procedure after excision and histological in sano resection. Completely acceptable aesthetic and functional deficits were obtained in 275 (96.4\%) patients over a 6-72-month follow-up. Ten (3.6\%) patients suffered postoperative complications. Two cases of local infection; one case of completely flap necrosis and seven cases of partial revision due to flap necrosis occurred. The level of satisfaction with the surgical long-term result reported by the patients was high. CONCLUSION: In our experience the bilobed Zitelli flap for covering defects in the area of the face showed very few complications and good aesthetic results