Top 4 ways to repair the skin after Mohs surgery for skin cancer: #2 The Skin Flap
A skin flap is one of the approaches used to close a wound after a skin cancer is removed by Mohs surgery. The decision to use a skin flap depends on a number of factors. Some of these include: the location and size of the wound; if letting the skin heal on its own or pulling the skin together in a straight line are not feasible options, or would result in a bad scarring or an inferior cosmetic result; previous surgeries or radiation therapy to the area involved; and others.
Essentially, a skin flap is a piece of tissue close to the to the wound or “recipient site” that is attached to a blood supply. This tissue is mobilized and placed over the recipient site to aid in repair.
There are a number of different types of skin flaps available to close the skin after Mohs surgery, and flaps are categorized in a number of ways. In essence, all flaps move and stretch the skin from the surrounding area to cover the surgical defect or wound.
The type of flap can be based on the direction the skin is stretched. For example, an advancement flap is used when the surrounding skin is stretched in a straight line. A rotational flap refers to the skin being twisted or rotated into place. Finally, a transposition flap is used when the surrounding skin is moved from an adjacent location over normal healthy tissue to cover the wound.
Skin flaps can also be based on the blood supply to the flap. All flaps need a blood supply so that they stay viable and heal the skin. Local flaps use a random blood supply based on the small (unnamed and non-defined) vessels in the surrounding skin. Axial flaps, on the other hand, use a specific artery or vessel to feed and supply the skin flap with nutrients while it is healing. The paramedian forehead flap is one example of an axial flap.
A skin flap is not always possible to perform especially if it is not in an area that has enough surrounding tissue to donate.
If you have been diagnosed with a skin cancer such as a basal cell carcinoma, squamous cell carcinoma or melanoma, or to schedule a consultation one of our board-certified dermatologists, please contact us today.
About the Author:
Dr. Adam Mamelak is a skin cancer specialist and fellowship-trained Mohs and reconstructive skin surgeon. Dr. Mamelak often refers to the process of repairing a wound left behind after Mohs surgery as “getting rid of the evidence.”
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