Island Pedicle Flap: A versatile and dependable technique for covering small to medium sized facial defects

Background: Facial skin defects following the excision of cutaneous neoplasia may present a reconstruction challenge. The island pedicle flap offers a versatile and dependable tool for reconstruction of a variety of facial defects. The aim was to evaluate our experience with the utility of the island pedicle flap in reconstruction of facial skin defects. Methods: : A retrospective assessment on 48 patients was small- to medium-sized facial skin defects were reconstructed with island pedicle flaps. The data was collected between November 2018 and December 2020. The reconstructions were performed in consideration of the relaxed skin tension lines and facial aesthetic unit concept. Results: : All defects were successfully covered with island pedicle flaps. The defect sizes varied from 0.2cm 2 to 9.5cm 2 . The outcome for the safety margins were as follows; 4 cases with 0.3 cm margin, 22 cases with 0.4 cm margin, 16 cases with 0.5 cm margin and 6 cases with 0.6 cm margin. Excision margins per pathology were compared to the BAD criteria; with 40 cases meeting the BAD criteria and 8 cases not. For this study, we focussed on two FACE-Q Skin Cancer Module scales. ‘Satisfaction with Facial Appearance’ had a highest score on the scale of 93% satisfaction and 19% of patients scored 71-82% on the scale. Regarding ‘Appraisal of Scar’, 79% of patients rated their outcome 82-100% on the scale. Conclusion: Considering the simplicity and safety of island pedicle flaps, this flap has been proven a reliable and a valuable tool.