Oncologic and Non-Oncologic Cutaneous Defects: Dermatologic Criteria and Reconstructive Strategies
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Abstract
Oncologic and non-oncologic cutaneous defects represent a frequent challenge in clinical practice, particularly when they are located in facial regions of high aesthetic and functional relevance. Proper management of these lesions requires careful integration of dermatologic criteria that guide oncologic resection and reconstructive principles that allow restoration of anatomy and function. Basal cell carcinoma is the most common cutaneous malignant neoplasm and, although it has low metastatic potential, it may generate significant defects when it involves photoexposed areas such as the cheek. This article presents a narrative review of the management of oncologic and non-oncologic cutaneous defects, emphasizing dermatologic criteria and reconstructive strategies, accompanied by a clinical case report of a 38-year-old female patient with basal cell carcinoma located in the right malar region. The patient was treated with surgical excision using adequate oncologic margins and immediate reconstruction with a Mustardé cheek rotation flap, achieving satisfactory functional and aesthetic outcomes with no evidence of tumor recurrence during follow-up. Through the integration of the clinical case and the literature review, epidemiologic factors, dermatologic evaluation criteria, and reconstructive principles influencing decision-making are highlighted. This comprehensive approach underscores the importance of individualized planning and an interdisciplinary strategy to optimize clinical and aesthetic outcomes in the management of facial cutaneous defects.
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References
I. Garg, P., Jain, R. K., Vashistha, A., & Khushalani, A. (2023). Aesthetic subunit reconstruction of basal cell carcinoma face. International Surgery Journal, 10(10), 1591–1594. https://doi.org/10.18203/2349-2902.isj20232979
II. Chen, H., Li, Q., Zhe, N., et al. (2025). Fine sutures combined with local flaps in the cosmetic repair of surgical defects of basal cell carcinoma of the head and face: a single-centre retrospective clinical study. European Journal of Medical Research, 30, 896. https://doi.org/10.1186/s40001-025-03163-5
III. Azeem, K. M. A., Abdelaal, S. M. A., Maguid, M. F. A., et al. (2024). Perforator-based local flaps for cutaneous facial reconstruction. Maxillofacial Plastic and Reconstructive Surgery, 46, 30. https://doi.org/10.1186/s40902-024-00435-8
IV. Villanueva López, J. A., Álvarez Padilla, A., Martínez Ferretiz, M. de los Á., Martínez del Ángel, D. A., & Estrada González, J. A. (2024). Case Report: Mustardé flap performance for reconstruction of the cheek in a patient with basal cell carcinoma in a second level of care. International Journal of Medical Science and Clinical Research Studies, 4(11), 2036–2041. https://doi.org/10.47191/ijmscrs/v4-i11-16
V. Fuenzalida Mery, L., Villalobos Cabrera, K., Miranda Palta, R., & Cabané Toledo, P. E. (2023). Colgajo de Mustardé como tratamiento de un carcinoma basocelular: a propósito de un caso. Revista de Cirugía, 75(4). https://doi.org/10.35687/s2452-454920230041812
VI. Juan, O. R., Baas, M. A., Juan, T. I., Barrientos, J. C., Lozano, J. L., Compean, J. E., & Cruz, A. (2025). Use of the Mustardé flap in facial reconstruction following surgery for cutaneous squamous cell carcinoma: a case report. International Journal of Research in Medical Sciences, 13(8), 3459–3463. https://doi.org/10.18203/2320-6012.ijrms20252420
VII. Malagón-Liceaga, A., et al. (2025). Medial canthus and lateral nasal wall reconstruction: case-based learning in post-keratinocyte cancer defects. Case Reports in Dermatology, 17, 48–53. https://doi.org/10.1159/000543603
VIII. Immediate local flap versus skin graft reconstruction after standard excision of basal cell carcinoma of the nose. (2025). JPRAS Open, 44, 364–374. https://doi.org/10.1016/j.jpra.2025.03.017
IX. Galán Suárez, R., Cabra Rozo, P. A., Rojas Páez, J. S., Luque Higuera, A. L., & Echeverry Fajardo, J. C. (2025). Resección y reconstrucción facial del carcinoma basocelular y escamocelular: una revisión de alcance. Revista Colombiana de Cirugía Plástica y Reconstructiva.
X. Chen, Y., & colleagues. (2025). Outcomes of microsurgical flap techniques in the reconstruction of advanced basal cell carcinoma defects. International Journal of Research in Medical Sciences.
XI. Mustardé flap reconstruction after basal cell carcinoma excision: case report and literature review. (2025). SAR Journal of Surgery, 6(4), 90–94. https://doi.org/10.36346/sarjs.2025.v06i04.005 s
XII. Local flap reconstruction using three or more flaps after Mohs micrographic surgery for skin cancer defects. (2024). Archives of Craniofacial Surgery.
XIII. De Vera, E., Magliano, J., & Bazzano, C. (2023). Large cheek defect reconstruction with a rhomboid flap and Burow’s advancement flap after excision of a basal cell carcinoma. Actas Dermo-Sifiliográficas, 114(8), 722–724.
XIV. Jonas, M. et al. (2023). Results of local flaps of the face for reconstruction after wide local excision in facial basal cell carcinoma. Journal of Facial Reconstruction and Aesthetic Surgery.
XV. Rogers, H. W., Weinstock, M. A., Feldman, S. R., & Coldiron, B. M. (2020). Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Archives of Dermatology, 146(3), 283–287.
XVI. Karia, P. S., Ward, B. A., & Han, J. (2020). Basal cell carcinoma: A comprehensive review. Journal of the American Academy of Dermatology, 82(4), 961–983.
XVII. Alsaif, A., Hayre, A., Karam, M., Rahman, S., Abdul, Z., & Matteucci, P. (2021). Mohs micrographic surgery versus standard excision for basal cell carcinoma: systematic review and meta-analysis. Cureus, 13(11), e19981.
XVIII. Leibovitch, I., Huilgol, S. C., Selva, D., Richards, S., & Paver, R. (2020). Basal cell carcinoma treated with Mohs surgery in Australia: Experience over 10 years. Journal of the American Academy of Dermatology, 53(3), 445–451.