背景与目的基底细胞癌是最常见的皮肤恶性肿瘤。BCC切除后缺损的重建应遵循亚基原则以获得更好的结果。基于面部单位来确定面部的BCC的位置;然而,很少有研究描述BCC中多个单元和多个亚基的参与。在这项研究中,我们旨在为涉及各种面部单位和亚单位的BCC管理提供有价值的见解,从而有助于改善患者护理和结果。材料和方法我们在Cuttack的SCB医学院整形外科进行了一项回顾性研究,奥里萨邦,从2020年1月至2022年1月,在获得SCB医学院IRB(编号:1155)的道德批准后。我们检查了35例面部BCC患者。纳入标准如下:早期和原发性肿瘤患者,没有附着在下面的骨骼或软骨上,并且适合手术切除。相反,晚期患者,被忽视,和复发性肿瘤,固定肿瘤,或那些浸润底层骨骼或软骨的患者被排除在研究之外.数据收集涉及从病历中检索相关信息,包括年龄等参数,性别,肿瘤部位,使用的皮瓣类型,后续行动,以及观察到的任何并发症。根据面部美学单位,将肿瘤部位进一步分为六个单独的组:前额,鼻子,眼睛周围的区域,脸颊,嘴巴,和耳朵周围的区域,每个都有自己的子单元。结果共纳入35例患者,包括15名男性(42.85%)和20名女性(57.15%),男女比例为1:1.33。患者的年龄范围为42至68岁。在面部单位中,鼻子是最常见的(七例),而嘴唇是最不常见的影响(在一种情况下)。在24个案例中,一个单位参与其中,而11例涉及多个单位。此外,18例单个亚基受到影响,10例双亚单位,五个案例中的三个亚基,一个案例中的四个子单元,和另一种情况下的五个子单元。值得注意的是,无皮瓣坏死,伤口裂开,伤口血肿,或血清肿,表明良好的手术效果。所有皮瓣保持有效,所有患者都接受了至少一年的随访,在6至18个月的随访期间没有报告复发,重申治疗方法的有效性。结论对于小,浅表病变,全层皮肤移植(FTSG)是一种合适的治疗选择。然而,当处理包含多个亚基的较大病变时,首选方法是用局部皮瓣重建。仔细计划程序至关重要,考虑到沿面部亚基交界处定位最终疤痕的目标。该战略计划旨在实现卓越的美学结果。
Background and objective Basal cell carcinoma (BCC) is the most common malignancy of the skin. Reconstruction of post-excisional defects in BCC should follow the subunit principle for better outcomes. The location of BCC of the face is determined based on facial units; however, very few studies have described the involvement of multiple units and multiple subunits in BCC. In this study, we aimed to provide valuable insights into the management of BCC involving various facial units and subunits, thereby contributing to improved patient care and outcomes. Materials and methods We conducted a retrospective study at the Plastic Surgery Department of the SCB Medical College in Cuttack, Odisha, from January 2020 to January 2022, after obtaining ethical approval from the SCB Medical College IRB (no: 1155). We examined 35 patients with BCC of the face. The inclusion criteria were as follows: patients with early-stage and primary tumors that were mobile, not attached to underlying bone or cartilage, and amenable to surgical resection. Conversely, patients with late-stage, neglected, and recurrent tumors, fixed tumors, or those infiltrating the underlying bone or cartilage were excluded from the study. Data collection involved retrieving pertinent information from medical records, including parameters such as age, sex, tumor site, type of flap utilized, follow-up, and any complications observed. The tumor sites were further divided into six separate groups based on facial aesthetic units: the forehead, the nose, the area around the eyes, the cheek, the mouth, and the area around the ear, each with its own subunits. Results A total of 35 patients were included in this study, comprising 15 males (42.85%) and 20 females (57.15%), with a male-to-female ratio of 1:1.33. The ages of the patients ranged from 42 to 68 years. Among the facial units, the nose was the most commonly involved (in seven cases), while the lip was the least commonly affected (in one case). In 24 cases, a single unit was involved, while 11 cases involved multiple units. Furthermore, single subunits were affected in 18 cases, double subunits in 10 cases, three subunits in five cases, four subunits in one case, and five subunits in another case. Notably, no cases exhibited flap necrosis, wound dehiscence, wound hematoma, or seroma, indicating excellent surgical outcomes. All flaps remained viable, and all patients were followed up for a minimum of one year, with no reported recurrence during the follow-up period ranging from 6 to 18 months, reaffirming the effectiveness of the treatment approach. Conclusions For small, superficial lesions, full-thickness skin grafts (FTSG) are a suitable treatment option. However, when dealing with larger lesions that encompass multiple subunits, the preferred approach involves reconstructing with locoregional flaps. It is essential to plan the procedure carefully, taking into account the goal of positioning the final scar along the junction of facial subunits. This strategic plan aims to achieve superior aesthetic outcomes.