Skin flaps and grafts are sometimes needed to help repair a wound following skin cancer surgery. Flaps and grafts are used if the skin cancer is large, and if the surrounding skin is difficult to move in order to close the surgical defect. Placing less tension on the wound results in better healing times, and less scarring. Flaps and grafts are commonly used for larger skin cancers on the nose, ears, temples and lower legs.
Important facts on flaps, grafts and skin cancer
Skin flaps are commonly used to close wounds from excisions of skin cancers. Most skin defects can be closed with normal elliptical excisions, however if the defect is large or if important cosmetic issues arise, we may elect to use a skin flap.
Skin flaps are geometric movements of skin from adjacent areas designed to close a defect. The type of skin flap used will depend on many factors including the size of skin cancer, and how much skin needs to be mobilised.
Common areas for skin flap skin cancer surgery include – the temples, nose, ears, forehead, and sometimes the lower legs.
Flap types include-
The type of flap used will depend on many factors including the location of the skin cancer defect, the movement of skin, and important cosmetic structures.
Full thickness skin grafts are often used to repair defects on the nose and ears.
Spilt thickness skin grafts are used to repair larger defects on the scalp, and lower limbs.
Donor sites are areas where the skin graft is harvested. Most common donor sites for the full thickness skin grafts include the front part of the ear, the collar bone area, and the back of the ear.
Split thickness grafts are usually taken from the upper thigh, or the back of the upper arm.
Healing times range from 9-21 days, depending on the type of skin graft, the location of the graft and other factors, including your general health and circulation.
Full thickness grafts on the nose and ears heal the fastest.
Split thickness grafts on the lower legs in elderly patients take the longest to heal.
Donor sites (from where the graft is harvested) take between 5 days (full thickness donor site) to 3 weeks (split thickness graft) to heal up.
Laser surgery can help improve the colour and texture of skin grafts and flaps. Red areas can be treated with the V Beam Vascular laser, whilst scar lines and contours can be evened out with several types of lasers, including the Erbium ProFractional Sciton laser, the CO2 CORE laser, or Fraxel lasers.
Most scars can be improved by 30-90% with a combination of laser techniques. Your doctor will refer you to a laser dermatologist if scar revision is needed.
Read more about scar revision following surgery