An Alternative single-stage application of the paramedian forehead flap in reconstruction of the face

Publication date: Available online 29 July 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Alessandro Innocenti, Marco Innocenti
BackgroundParamedian forehead flap represents a workhorse in facial soft tissue reconstruction but always requires a second step in order to interrupt the skin bridge. Direct visualization and dissection of vascular pedicle may avoid this drawback.Methods21 patients were treated between January 2012 and January 2014: 6 underwent nasal reconstruction and 15 full thickness defect of medial canthus of an orbital region. The follow-up ranges between 6 months and 2 years. All procedures were carried out in a single stage.ResultAll flaps were performed in a single-stage procedure, survived and healed uneventfully.ConclusionThe authors describe a refinement of the original technique to be reserved for cases where vessels could be identified by Doppler, consisting in the direct visualization and dissection of the initial tract of the vascular pedicle, thus providing an extremely mobile pedicle whose size allows to locate the first part of the pedicle in the nasion, tunneling under a skin bridge between the emergence of the vessels and the defect.



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