Skin flaps and grafts (basics) — SAQ

Stem

A 67-year-old man undergoes Mohs excision of a basal cell carcinoma on the distal nasal sidewall, leaving a 1.2 cm superficial defect with a well-vascularised bed. He smokes 10 cigarettes daily. Another patient has a large granulating pretibial wound after excision of a squamous cell carcinoma with clear margins.

Questions

a) Define the difference between a skin flap and a skin graft. (2 marks)

b) For the nasal defect, list three reconstructive options and justify a preferred choice (e.g. bilobed flap vs FTSG vs secondary intention) considering site and smoking. (3 marks)

c) Outline the three classic phases of skin graft take. (3 marks)

d) Name two early complications that threaten flap or graft survival and the first action for expanding haematoma. (2 marks)