R.G. Khamidullin1, R.I. Minvaleev1, A.N. Rudyk2,4, V.A. Chernyshev1, M.A. Busygin1, A.R. Utkuzov1,3, M.R. Khamitov1
1Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after professor M.Z. Sigal, Kazan
2Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan
3Kazan State Medical University, Kazan
4Kazan (Volga Region) Federal University, Institute of Fundamental Medicine and Biology, Kazan
Khamidullin Rinat G. ― Cand. of Sci. (Med.), Head of the Oncology Department №5 (head and neck tumors) of the Tatarstan Cancer Center
29 Sibirskiy tract, Kazan, 420029, Russian Federation, tel. (843) 202-27-40, e-mail: firstname.lastname@example.org
The aim of the research ― to study the possibilities of reconstruction of complex postresection defects of cover tissues of the head with free split-thickness skin graft in cases of malignant skin neoplasms.
Material and methods. The research is concerned with the results of surgical treatment of 165 patients with malignant neoplasms of scalp who underwent medical treatment in the head and neck carcinoma department of Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after professor M.Z. Sigal from 2016 to 2020. 120 patients were diagnosed with basal cell carcinoma, 33 ― with squamous cell carcinoma, 4 ― with skin appendage cell carcinoma and 8 ― with melanoma. Different kinds of distant flaps were used for a post-surgical deformity’s plastic reconstruction on 93 patients, local flaps grafting ― on 16 patients and free split-thickness skin graft (FSG) plastic reconstruction was performed on 54 patients. Amongst 54 patients who underwent FSG plastic reconstruction graft was taken on 18 patients manually and on 36 patients by using dermatome.
Results. 53 patients had full FSG reimplantation not only on the hairy part of the head but also on the other zones where the host bed represented by soft tissues with complex texture of skin surface. In one case total necrosis of FSG has been observed. The treatment outcomes were observed on all 54 patients for a period from 6 months to 4 years. Two patients with locally advanced basal cell carcinoma of hairy part of the head in 8 months and 2 years after the surgery were diagnosed relapse in the area of the graft, although primarily resection R0 was undertaken. There were no fatalities.
Conclusion. The result of a plasty with free skin graft does not depend on the method of sampling the skin graft, even when it is used for closure postresection facial defects with complex texture defects. Observance of the fundamental principles of FSG plastic reconstruction and postoperative care of this category of patients is a key to successful reconstruction.
Key words: skin cancer of the head, free skin graft, plasty, complex texture.