PDF icon PDF herunterladen
Open Access
CC BY 4.0 · Arch Plast Surg 2025; 52(01): 030-035
DOI: 10.1055/s-0044-1788780
Pediatric/Craniomaxillofacial/Head and Neck
Original Article

Minimizing Surgical Margins in Basal Cell Carcinoma: A Single Institution's Experience with Excision and Reconstruction Methods

Sang-Oh Lee 
1   Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea
,
Tae Gon Kim 
1   Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea
,
Kyu Jin Chung 
1   Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea
› Institutsangaben
Funding This work was supported by the 2023 Yeungnam University Research Grant.
› Weitere Informationen
  Lizenzen und Reprints
Preview

Abstract

Background Basal cell carcinoma (BCC) is the predominant nonmelanocytic skin cancer, with preservation of both function and aesthetics being essential during tumor removal. Existing surgical margin guidelines primarily target ill-defined BCCs prevalent in Western countries. Therefore, this study aims to demonstrate the efficacy of surgical removal, propose modified guidelines for wide excision tailored to Asian patients, and share experiences with various reconstruction methods.

Methods This study encompasses 418 patients (447 cases) who underwent BCC excision from March 2015 to June 2023 at our institution. Wide excision extended 2 mm beyond the tumor edge universally, with an additional 2 mm resected if tumor cells persisted in the frozen biopsy, followed by appropriate reconstruction. Patient demographics, tumor features, reconstruction methods, complications, and recurrence rates were analyzed.

Results Predominantly, reconstructions involved local flaps (244), skin grafts (102), and direct closure (72). Significant differences were noted in age, location, and tumor size among these groups. The rate of second resection increased from upper to lower facial subunits, peaking at 11.1% in the lower subunit, with a statistically significant difference (p = 0.024). Additional resection was required in 5.50% of cases, with a significantly higher incidence of ill-defined borders, pigmentation, and the infiltrative subtype compared with others. Complications were minor; recurrence occurred in only one case, 6 months postinitial nasal dorsum surgery.

Conclusion Surgical excision is highly effective, supported by various reconstruction options. We propose narrower guidelines for wide excision considering tumor characteristics and recurrence locations, resulting in smaller defects addressed with simpler reconstruction methods.

Keywords

basal cell carcinoma - wide excision - frozen biopsy - reconstruction

Authors' Contributions

Conceptualization: K.J.C. Data curation: S-O.L., T.G.K., and K.J.C. Formal analysis: S-O.L. and T.G.K. Investigation: S-O.L. Methodology: S-O.L. and K.J.C. Project administration: K.J.C. Visualization: S-O.L. and T.G.K. Writing—original draft: S-O.L. Writing—review and editing: T.G.K. and K.J.C.


Ethical Approval

This study was approved by the Institutional Review Board of Yeungnam University Hospital (IRB Number YUMC 2024-01-002).


Patient Consent

Informed consent was obtained from all participants.


Supplementary Material



Publikationsverlauf

Eingereicht: 22. Januar 2024

Angenommen: 13. Juli 2024

Artikel online veröffentlicht:
27. Dezember 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA