Subcutaneous island pedicle flap is based on the basic principle of V-Y advancement and closure. This advancement flap involves the isolation of a segment of skin as an island disconnected from the peripheral epidermal-dermal attachment. Subcutaneous island pedicle flap offers several distinct advantages over various transposition flap and skin graft. Moreover its design and execution are straightforward, being a conceptual extension of the elliptical excision technique. Four cases of malignant tumors on the face were removed by Mohs surgery, followed by reconstruction of defects with subcutaneous island pedicle flap. In our cases, there were no significant complications and the results were cosmetically acceptable. Subcutaneous island pedicle flap is a simple and satisfactory alternative for the reconstruction of medium-sized defects in the face.
Mohs Surgery ; Skin ; Transplants

17 patients with scar due to the burn (77%) and congenital pigment in the head and face, ages of 1-44 received plastic surgeries in the National Institute of Burn of which facial lesion and head skin lesion due to many different causes. The results have shown that frontal skin stretch bags were suitable for local lesions. The head skin stretch bags with hair were suitable for the lesions in the adjacent region.
Surgery, Plastic ; Skin Pigmentation ; surgery ; therapeutics

BACKGROUND

Mohs micrographic surgery (MMS) is the preferred surgical procedure for non melanoma skin cancers (NMSCs), especially in areas where function and cosmesis are critical. It allows precise removal of the tumor while preserving normal skin tissue.

This study aimed to describe the clinicohistopathologic profile of patients who underwent MMS at the Dermatology Center of the St. Luke’s Medical Center, Quezon City, Philippines (SLMC-QC) from March 2003 to March 2023.

This was a descriptive cross-sectional study utilizing a 20-year chart review on all patients who underwent MMS at SLMC-QC from March 2003 to March 2023. Data collected were the following: age, sex, race, clinicopathologic diagnosis, tumor site, pre-operative and post-operative area size, number of MMS stages, type of repair performed, and recurrence, if any.

In 20 years, there were a total of 684 cases done in the Dermatology Center SLMC-QC, and 573 cases with complete data were included. Eighty six percent of patients were over 50 years old. There was a slight male predominance, and most patients were Asians, followed by Caucasians. Basal cell carcinoma was the most common diagnosis followed by squamous cell carcinoma and Bowen’s disease. Majority of the tumors were located on the head and neck. The postoperative defect increased by 2-to-3-fold from the preoperative tumor size in most cases. Most tumors were cleared in 2 stages. The most common type of repair done was flaps, followed by full-thickness skin grafts and primary closures. All primary tumors treated in the center have not recurred within 5 years, bringing the cure rate to 100%.

The clinicohistopathologic profiles of patients in this study are similar to those reported in the literature. No recurrence has been reported in the center and this reflects the effectivity of MMS.

Syringoid eccrine carcinoma is a rare adnexal tumor of eccrine origin, and has metastatic potential and high recurrence rate following conventional surgical excision. Mohs micrographic surgery has been commonly used for various malignant skin cancers to minimize the defect after surgery, and to decrease the recurrence rate. We present a case of syringoid eccrine carcinoma successfully treated by Mohs micrographic surgery.
Mohs Surgery* ; Recurrence ; Skin Neoplasms

Dermatofibrosarcoma protuberans(DFSP) is an uncommon recurrent soft-tumor of skin and is locally highly invasive and aggressive, although it rarely metastasizes. When possible, of the many treatment modalities, the surgical excision is indicated primarily. There are three surgical modalities, which are excision with undefined or conservative surgical margins, excision with wide surgical margins and Mohs micrographic surgery(MMS). And the classical standard surgery was the local wide excision with at least 3cm margin around the primary tumor and through the deep fascia. However recent studies has showed that MMS decreased the recurrent rate of the tumor, conserving the normal uninvolved tissue, and MMS is accepted as the first choice treatment modality of DFSP. Some studies reported that the margin of 2.5cm is necessary to clear the tumor in MMS. We present two cases of recurrent DFSP treated by Mohs micrographic surgery, one through 4-staged resection, the other, 3-staged resection of the tumor.
Dermatofibrosarcoma* ; Fascia ; Mohs Surgery* ; Skin

Six volatic kite flaps were used to covering the missing lesions of thumb skin. The flaps were collected from dorsum of phalanx 1 and from hand-finger join 2. The flaps involved three feeding components: the dorsal finger 2 artery that separated from radial artery, vein, the nerve branch that separated from radial nerve. These flaps were used effectively for covering the missing lesion of inter-phalangeal joint 1-2. It is more difficult in covering the palm of phalanx 2 of finger 1 because the flap must be collected from far area, the blood supply is poor in distal tip and the flap is stretched. (There was one case in which this flap was used to cover the palm of phalanx 2 of finger 1 had necrosis in distal part of the flap).
Skin ; Thumb ; Surgical Flaps ; surgery

Skin is the largest organ in human body. It guards the underlying muscles, bones, ligaments, and internal organs. The skin faces the environment, and it is the first line to defend against the assaults of external physical, chemical, and micro-organic factors. The other functions of skin include systemic metabolism, temperature regulation, sensation, and production of vitamin D and folate. Skin injury usually leads to barrier function damage. Extensive skin injury would induce a series of problems such as water-electrolyte disorder, hypoproteinemia, and severe infection. Thus it is important to choose a suitable wound dressing when the skin is severely injured. The characteristics of wound dressings have undergone repeated and noticeable changes over the last several years. Compared with that of the traditional dressing, the ability of new dressings is improved obviously in the properties of wound protection, infection prevention, and wound healing promotion. This article deals with an overview on the characteristics of different wound dressings.
Bandages ; Burns ; surgery ; Humans ; Skin ; injuries ; Skin, Artificial ; Wound Healing

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

Skin grafting is one of the two major surgical procedures to repair losses of skin tissue. For severely burned patients, the autologous donor skin is not enough to cover extensive wounds. Therefore, several types of mixed skin grafting have been developed in the past fifty years. Two of them, the intermingled skin grafting and microskin grafting overlaid by a sheet of allogeneic skin, have been widely applied in the treatment of major deep burn patients, resulting in a and significant decreased of the mortality. Two other methods, i. e, mixed grafting of autologous and allogeneic microskin or keratinocytes are still under investigation. In this review, we summarize the evolution of mixed skin grafting, introduce the classification of mixed skin grafting, analyze their merits and demerits, and distinguish it with composite skin grafting or transplantation. The perspective of mixed skin grafting will be focused on three aspects, i. e, prolonging the survival of allograft by induction of donor-specific immune tolerance, accelerating the wound healing by strengthening the interactions between the keratinocytes and fibroblasts, and decreasing the wound scarring and contraction by optimizing the amounts of cellular or acellular allogeneic dermis.
Burns ; surgery ; Humans ; Skin Transplantation ; Skin, Artificial ; Wound Healing