Palliative Surgery

Abstract

Facial defects following cancer excision may be too extensive for simple closure or local flaps. Pedicled or free flaps may be appropriate for these larger and more complex defects. Pedicle flaps are generally faster to raise, do not require specialised training or equipment and may be more appropriate for frail patients with multiple pre-existing co-morbidities. Pedicled flaps, however, may be limited in their anatomical reach, and the bulk of the pedicle may compromise the aesthetic outcome. Free flaps allow the movement of specific combinations of skin, soft tissue and bone for large and complex defects. Surgery may be extensive. Consideration of patient suitability, defect characteristics and surgeon skill and expertise will guide the selection of the most appropriate flap for the defect.