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49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen e. V. (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen e. V. (VDÄPC)

29.09. - 01.10.2011, Innsbruck

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Comparative study of the 2-stage and 3-stage techniques of paramedian forehead flap for nasal reconstruction

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  • author Adelana Santos Stahl - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart
  • Stéphane Stahl - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart
  • Christoph Meisner - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart
  • Sebastian Haack - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart
  • Helmut Fischer - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart
  • Wolfgang Gubisch - Marienhospital Stuttgart, Zentrum für Plastische Chirurgie, Klinik für Plastische Gesichtschirurgie, Stuttgart

Österreichische Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie. Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Innsbruck, 29.09.-01.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgpraecV96

doi: 10.3205/11dgpraec097, urn:nbn:de:0183-11dgpraec0979

Published: September 27, 2011

© 2011 Santos Stahl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: Whereas traditionally in nasal reconstruction the paramedian forehead flap is transferred in two stages, a forehead flap technique in 3 stages has been described as minimizing the risk of flap necrosis by adding an intermediate operation to perform flap thinning post flap transfer and prior to pedicle division. The 2 and 3-stage techniques of paramedian forehead flaps for nasal reconstruction were therefore compared to determine the incidence of complications related to each procedure.

Materials and methods: In a retrospective study, 187 forehead flaps performed for nasal reconstruction between July of 2003 and February of 2009 were divided into 2 groups. In group A, 87 forehead flaps were transferred in 2 stages and in group B 100 forehead flaps in 3 stages. An index was developed to assess the level of complexity of nasal reconstruction.

Results: Age, sex distribution, possible surgical risk factors and causes of the nasal defects were very similar in both groups while the nasal reconstructions were more complex in group B. Complications arose in 17.2% and 17% of patients in group A and B respectively. Although not statistically significant, the percentage of forehead flap necrosis (A: 3.4%; B: 5%) and infection (A: 1%; B: 5%) in group B was superior to group A.

Conclusions: The complexity of the nasal reconstructions and the severity of complications were greater, and the hospitalization longer in the 3-stage group although the overall incidence of complications was similar in both groups. This comparative retrospective study did not find any evidence to support the assumption that the 3-stage technique is associated with lower risks of necrosis.