PREVENTION AND TREATMENT
Flap Surgical Removal
Nose
The patient had skin cancer on the right side of the nose. A graft was considered for repair; however, the patient had a previous graft on his nose and was hoping for a less obvious scar. A V-Y flap was designed to move loose skin from the cheek to the side of the nose without pulling at the eyelids.
The second image shows the wound immediately after surgery. The "triangle" was deliberately stitched down to counter any "pin-cushioning" of the wound, which occurs when the flap bulges upwards—a common complication of this surgical technique.
The third image shows that the final scar is well hidden and the flap height matches the surrounding skin. The patient was happy with the outcome.
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Foot
The size of the lesion was too large for a simple elliptical closure. A graft is typically a common option for closing wounds on the top of the foot. However, this patient was hesitant about the idea of a graft due to a neighbor's experience with a chronically non-healing graft that lasted for several months. Consequently, we opted for a "keystone flap." One advantage of this method is that it creates a more robust healing wound, allowing the patient to return to normal activities sooner.
As shown in the final photo taken 12 months on, an excellent surgical outcome was achieved with minimal scarring and a reduced healing time.
Hand
This gentleman spent his working life as a bricklayer and has had multiple skin cancers removed including this one on his Left hand.
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Once the sutures were in place, I asked the patient to make a fist to ensure that the wound wasn’t too tight, allowing him to use his hand comfortably.
This is a rotational flap; initially, the wound edges may not appear very healthy. However, with ongoing moisturizing using Vaseline, the wound begins to heal well.
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A few months later, the scar has become quite difficult to see
More flap procedures
