Final answer:
For closing the wound from a squamous cell carcinoma excision on the lateral aspect of the nose with exposed alar cartilage, a local rotational flap or full thickness graft is preferred to match color, texture, and contour of the facial structure.
Step-by-step explanation:
When dealing with a surgical excision of a squamous cell carcinoma from the nose where the alar cartilage is visible at the end of the operation, the best method of closing the wound is dependent on the size and location of the defect. However, considering the specific area involved (the lateral aspect of the nose) and the exposure of alar cartilage, a local rotational flap or a full thickness graft are generally the preferred options. A local rotational flap would bring adjacent tissue into the defect area, allowing for a matching color, texture, and contour to the facial structure. A full thickness graft, usually taken from an area like behind the ear where the skin is similar in texture and color, could also be utilized to close the defect.
An interrupted 3/0 silk might be used for suturing but is not a method for closing a significant defeact. Split thickness grafts are typically used for larger wounds that don't require the same aesthetic considerations as the face, while a vacuum assisted closure system is typically used for temporary wound management, not definitive closure of the surgical site. Therefore, the best methods in this scenario are either a local rotational flap or a full thickness graft.