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Analysis of Uncovered Subcutaneous Hinge Flaps Allowed to Heal by Secondary Intention

Paul van der Eerden, MD; Mark Simmons, MA(Oxon), FRCS(ORL-HNS); Hade Vuyk, MD, PhD

Arch Facial Plast Surg. 2008;10(2):131-136.

Objective  To describe the experience of a single department using uncovered subcutaneous hinge flaps to repair the nasal portion and adjacent facial subunits of defects after skin tumor excision.

Design  Case series of 16 patients needing reconstruction for lesions of the alar subunit with 1 or more adjacent facial subunits after Mohs surgery for cutaneous malignant neoplasms.

Results  All flaps healed well by secondary intention, and the results were gauged at least satisfactory by the patients and surgeons. In 4 patients there were minor aesthetic concerns: in 1 patient the underlying cartilage graft was prominent and a minor revision was undertaken, 1 patient had effacement of the nasofacial sulcus, 1 patient developed a hypertrophic scar, and 1 patient developed both effacement of the nasofacial sulcus and a scar.

Conclusions  The use of subcutaneous hinge flaps allowed to heal by secondary intention is a simple 1-stage technique that may be useful in reconstruction of small but deep nasal sidewall defects.

Author Affiliations: Department of Otolaryngology, Lange Land Hospital, Zoetermeer, the Netherlands (Dr van der Eerden); Department of Otolaryngology, Walsall Manor Hospitals NHS Trust, Walsall, England (Dr Simmons); and Department of Otolaryngology and Facial Plastic Surgery, Gooi-Noord Hospital, Blaricum, the Netherlands (Dr Vuyk).