Search Results (4)

Background: The rising incidence of cutaneous non-melanoma skin cancers underscores the need for individualized reconstruction, particularly for cheek defects that pose distinctive anatomic and functional challenges. This study aimed to analyze reconstructive patterns for cheek skin lesions and to develop a simple, site- and size-based algorithm for small- to medium-sized defects. Methods: We retrospectively reviewed 129 consecutive patients treated between 2022 and 2025 for primary basal cell carcinoma, squamous cell carcinoma, or benign cheek skin tumors. After excision, defects were reconstructed with primary closure, local flaps, or skin grafts. Associations between the largest clinically measured lesion diameter (used as a proxy for the post-excision defect size), anatomical subsite, histopathology, and reconstructive technique were evaluated using ANOVA or Kruskal–Wallis tests, chi-square tests, and Spearman’s correlation. Results: The mean lesion diameter was 19.75 ± 12.93 mm. Reconstruction was performed using local flaps in 62 patients (48.06%), primary closure in 53 (41.09%), and skin grafts in 14 (10.85%). Larger defects were more frequently managed with grafts or flaps (F(2,110) = 4.84, p = 0.010), and lesion size correlated with reconstructive complexity (Spearman’s ρ = 0.229, p = 0.015). Lesion location was also significantly associated with the reconstruction method (χ²(10) = 48.29, p < 0.001; Cramér’s V = 0.44). Margin-negative (R0) excision was achieved in 95.35% of cases, with a low recurrence rate (3.91%) and complication rate (1.56%). Conclusions: Lesion size and anatomical location are key determinants of reconstructive strategy for cheek skin defects. In this cohort, lesions ≤ 20 mm were predominantly managed with primary closure, whereas lesions > 20 mm more frequently required flap reconstruction or skin grafting. This size-based split is cohort-derived and should be interpreted as a pragmatic framework that requires external validation. Full article

Background: Large lateral cheek defects can be challenging to reconstruct. Several approaches to reconstruction of these defects have been reported. In the case presented here, we describe an alternative reconstruction method for this type of surgical defect. Detailed Case Description: We present one patient with a large basal cell carcinoma on his lateral left cheek who underwent a complete tumor removal by Mohs surgery and was left with a defect 6 × 6 cm in size. This large defect was closed by performing a double transposition flap under local anesthesia. Results: Both flaps survived with no loss. The immediate and long-term outcomes were satisfactory, preserving functionality with good cosmetic results. Conclusions: Cheek defect reconstruction with the double transposition flap is simple and reliable, with good aesthetic and functional outcomes. It may be considered as an alternative reconstructive method for this type of defect, in an appropriate context. Full article

(1) Background: The reconstruction of cutaneous defects following surgical procedures in the nasal pyramid presents a challenge due to the limited amount of available tissue. In cases of larger defects, skin from adjacent units is used. Traditionally, two-stage surgical flaps have been employed for reconstructing these defects. Tunnelized island flaps allow for the one-stage surgical reconstruction of nasal pyramid defects, using tissue from the forehead or cheek for the flap. (2) Methods: Descriptive retrospective study of 21 consecutive patients who underwent surgery for defects on the nasal pyramid using tunnelized island flaps. (3) Results: Surgical reconstruction was performed in 21 patients with basal cell carcinomas, 14 of them using the melolabial island flap and 7 using the paramedian forehead island flap. In all cases except one, clear histological margins were obtained. Immediate complications were mild and minor. It is worth noting the trapdoor effect complication, which improved over time in most cases, resulting in a satisfactory cosmetic outcome. No tumor recurrences were observed during an average follow-up period of 17.7 months. (4) Conclusions: Tunnelized island flaps allow for single-stage reconstruction of nasal pyramid defects, yielding excellent cosmetic results by utilizing adjacent skin. This procedure demands a certain level of skill but is associated with minimal complications, making it a valuable alternative in reconstructive dermatological surgery. Full article

Fruit cracking is one of the main concerns in sweet cherry production and is caused by a heavy rainfall before and during the harvest. This physiological disorder leads to severe economic losses, which can be more or less effective depending on the cracked region of the fruit: in the cheeks (side cracks), in the stylar scar region, or in the stem cavity region. Sweet cherry cracking can be affected by several factors such as cultivar, growing conditions, rootstock, fruit size, flesh osmotic potential, cuticular characteristics of the skin, and stage of fruit development. In this sense, the objective of this work was to evaluate the cracking incidence in two sweet cherry cultivars (Early Bigi and Lapins grafted on “Saint Lucie 64” rootstock) and correlate the cracking index with other quality parameters. Fruits were harvested on 2 May (cv. Early Bigi) and on 27 May (cv. Lapins) 2019 at their commercial ripening stage. In the field, the total yield and the trunk cross-sectional area were determined for each tree in order to calculate the yield efficiency. In the laboratory, the cracking index was determined in 150 fruits without visual defects. In addition, fruit size and weight, wax content, flesh firmness, epidermis rupture force, total soluble solids, pH, titratable acidity, and maturity index of 30 fruits were also evaluated. In general, all the analyzed quality parameters were influenced by the cultivar, being that cv. Lapins presented larger, heavier, firmer, and sweeter fruits, with more acidity and higher maturation index. However, cv. Lapins also presented higher cracking index, which was positively correlated with all the parameters above-mentioned and negatively correlated with the wax content. In fact, cv. Early Bigi presented a high wax content and simultaneously a low cracking index. The stylar scar region cracks were the most prevalent in both cultivars. These results allowed us to conclude that, in the North Portugal region, the Lapins cherries presented better quality attributes than the Early Bigi cherries. However, the latter are still very valuable to the region due to its early ripening. Additionally, it was also possible to conclude that bigger, firmer, more mature, and with lower wax content cherries were more sensitive to cracking than the smaller fruits, soft-fleshed, less mature, and with higher wax content. Full article