Reconstruction of defect of medial canthus with full-thickness skin graft
18 April 2018 (online)
Introduction – Objective:
Basal cell carcinoma (BCC) is by far the most common cancer amongst Caucasians. Approximately 85% of BCC occurs on the face, and 25 – 30% of periocular tumors affect the medial canthus. Most authors advocate the use of flaps in reconstructing post excision defects in the region of medial canthus. We aim at presenting the treatment of a T2 BCC of medial canthus with grafting with full-thickness skin graft.
Material – Method:
We had to deal with a 92-year-old female suffering from a T2 BCC of left medial canthus spreading to nasal pyramid. After excision under local anesthesia, a full-thickness skin graft was harvested from the clavicular area and sutured to cover the defect (Photo presentation).
Immediately postoperatively epiphora was present – most probably due to pressure of usual coverage that is sutured on full-thickness skin grafts. However, it resolved completely 3 weeks later. Otherwise, follow-up shows excellent results both from the aesthetic and functional (movements of upper and lower lid) point of view (Photo presentation). No recurrence has been observed so far.
Though most authors are rather skeptical if not against the use of full-thickness skin grafts in the region of medial canthus we believe that the meticulous use of such a graft can be mostly beneficial for our patients, if not for anything else, at least for protecting them from extra facial scars caused by operations involving flaps.