The interpolation nasolabial flap: the advantageous solution for nasal tip reconstruction in elderly and polymorbid patients.

BACKGROUND: Nasal tip is one of the most frequent areas affected by basocellular carcinoma. The treatment must avoid any postsurgical deformity, as the nasal tip is the main part of the facial triangle. Most of these patients are elderly and polymorbid. The surgeon must find a compromise between the cosmetic effect and an acceptable stress for the patient. METHODS: There were five methods of nasal tip reconstruction used on a group of fifty elderly patients with various medical comorbidities: skin graft, bilobed flap, dorsal nasal flap, forehead flap and interpolation nasolabial flap. The resulting cosmetic effect was objectivized by a standardized questionnaire and the advantages and disadvantages of each method were discussed. RESULTS: According to the characteristics that were considered (good vascular supply, matching skin color and texture, sufficient amount of material, possibility to cover exposed cartilage or to combine it with cartilaginous graft; scars of minimal visibility, perfect aesthetic outcome, use of local anesthesia, short surgical time, and technical simplicity) was the interpolation nasolabial flap found as the most appropriate. CONCLUSION: Interpolation nasolabial flap is an easy and effective method for treatment of smaller and middle-sized defects of the nasal tip with minimal stress for the patient. LEVEL OF EVIDENCE: Level III.

Laceration and degloving injury of a child's foot--a case report.

Laceration and degloving injury to a child's foot is quite a rare occurence, mostly resulting in persistent consequences. Treatment options for such an injury depend on the specific type of injury and the customary practice of each surgical department. The authors present the interesting case of 4-year-old boy with laceration and degloving injury to his right foot after a collision with a truck, suggesting simple treatment using skin graft which has an excellent functional and cosmetic effect. Several methods have been described in management of this kind of injury, such as microvascular free tissue transfer, free or local flap and skin graft. A full-thickness skin graft was used in this case with good result, and in our opinion this treatment option need not be reserved for plastic surgeons.