Question

A 68 year old lady has a 3cm basal cell carcinoma excised from her right cheek. There is a rhomboid defect measuring 4cm by 4cm. What is the best option for managing the wound?

a. delayed primary closure
b. direct primary closure
c. local rotational flap
d. split thickness skin graft
e. pedicled myocutaneous flap

Answer 1

The best management for a 4cm by 4cm rhomboid facial defect after basal cell carcinoma excision in an elderly patient would be a local rotational flap due to its superior cosmetic outcomes on the face.

Step-by-step explanation:

The best option for managing a 4cm by 4cm rhomboid defect on the cheek of a 68-year-old lady after excision of a basal cell carcinoma is likely to be c. local rotational flap. This method allows for the movement of tissue from an adjacent area to cover the defect, ensuring a good cosmetic result and color match, which is crucial on the face. Options like a split thickness skin graft might not provide the best aesthetic outcome, while a pedicled myocutaneous flap is usually reserved for larger defects or when local tissue is not available. Both delayed primary closure and direct primary closure are typically not feasible for a defect of this size located on the face.