Modified Dermis Graft for Basal Cell Carcinoma Defect of the Nose

Abstract

Basal cell carcinoma (BCC) is the most common cutaneous cancer of the nose and is characterized by its local spreading and exceptionally rare tendency to metastasize. Surgical excision ensuring the highest chance of cure is frequently employed. Excision defects of the nose may be reconstructed with local flap, for which there are concerns regarding precise design and visible donor site scar.
In covering such defects following excision of basal cell carcinomas, we favor the technique of dermis grafting, which is a de-epithelialized split-thickness skin graft. It was reported by Han et al. in 2007 to restore the epidermis portion of the recipient site by inducing epithelialization from adjacent skin. The color and texture of the dermis graft match well with the skin of the nose region; however, it has the problem that the graft is harvested from the loaded portion of the buttocks. Therefore, we modified the donor site from the gluteal area to the inguinal area.
Using our method, modified dermis graft technique, a graft can be harvested in an unloaded portion without a precise design or visible donor site scar. Satisfactory results, both clinically and in patient appreciation, have been obtained in terms of both the reconstruction site and the appearance of the donor site in all patients.