ObjectiveTo explore the effectiveness of propeller facial artery perforator flap to repair the defect after resection of skin malignant tumor at upper lip.MethodsBetween July 2012 and January 2017, 17 cases with skin malignant tumor at upper lip underwent tumor resection and the remained defect was repaired with propeller facial artery perforator flap. Among the 17 patients, 3 were male and 14 were female, with an average age of 57 years (range, 35-82 years). There were 5 cases of squamous cell carcinoma and 12 cases of basal cell carcinoma. The disease duration ranged from 4 months to 11 years with an average of 20 months. The tumor size ranged from 1.4 cm×0.3 cm to 3.1 cm×1.4 cm. The extended resection of the tumor tissue was performed according to the characters of tumor. According to the location, size, and shape of the defect and the position of facial artery perforator explored with Doppler ultrasonography, the propeller facial artery perforator flap was designed to repair the defect and partial donor site. The flap size ranged from 5 cm×2 cm to 7 cm×3 cm. The length of the perforator pedicle was 0.5–1.0 cm with an average of 0.8 cm. The defect at donor site was directly closed.ResultsCyanosis occurred in 3 cases of the distal flap after operation, then healing after symptomatic treatment. The remaining flaps survived successfully and the wound healed by first intention. Primary healing was obtained in the donor site. All the patients were followed up 6-36 months with an average of 18 months. The shape of the patient’s upper lip was good and the scar on the donor site was unconspicuous. There was no lip deformity, ala nasi deflection, facial tension, entilation dysfunction, or recurrence of tumor during follow-up. At last follow-up, the results of self-evaluation were very satisfactory in 13 cases and satisfactory in 4 cases.ConclusionBased on multiple advantages of good blood supply, large rotation range, aesthetic outcome, and slight injury of the donor site, propeller facial artery perforator flap is not only an optimal choice for repairing upper lip defect after resection of skin malignant tumors, but also can achieve good functional and cosmetic effectiveness.
Objective
To summarize the present status and progress of the anatomy researches and clinical application of the facial artery perforator flap (FAPF).
Methods
The relative researches focused on the anatomy researches and clinical application of FAPF were extensively reviewed, analyzed, and summarized.
Results
The facial artery perforator (FAP) has constant anatomy. There are more facial artery perforators in the perioral region, and each FAP has two accompanying veins. Distinguished by inferior mandibular border, the upper and the lower flaps both are used for reconstruction of defects on the face. The most widely-used upper flap was FAPF, which is excellent choice of defects in mid-face. Additionally, angular artery perforator flap and lateral nasal artery perforator flap are becoming more and more popular. While submental artery perforator flap, whose pedicle locates under inferior mandibular border, is most used for reconstruction of lower face. FAPF for face defect repair can achieve good outcomes of function and appearance in clinical application.
Conclusion
Based on multiple advantages of good aesthetics and function outcomes, high survival rate, flexible design, and simple operation, FAPF is an optimal choice for defect repair of perioral region and nasal ala. However, Further study is needed to determine whether retaining tissue around the pedicle will affect vein reflux of the flap.
