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Extended Central Artery Perforator Propeller Flap for Large Nasal Defects

Baltu, Yahya MD*; Dölen, Utku C. MD; Aydin, Orhan MD

doi: 10.1097/SCS.0000000000005672
Clinical Studies

Various local flaps have been defined for small skin defects of the nose. However, the repair of large nasal defects is only possible with flaps allowing a large tissue transfer, such as a free flap, forehead flap, and nasolabial flap. In this study, large nasal defects were reconstructed with extended central artery perforator propeller (CAPP) flaps in an attempt to describe a single-stage procedure as an alternative technique to the median forehead flap. Thirteen large nasal skin defects, including dorsum and nasal sidewall and/or dome, were repaired with a CAPP flap between January 2015 and March 2018. A total of 13 patients aged 19 to 92 years were included. The mean follow-up period was 14.9 months. Pathological diagnoses were basal cell carcinoma in 5 patients, squamous cell carcinoma in 6 patients, and trauma in 2 patients. Defect size ranged between 3 × 3 and 4 × 5 cm. Flap size ranged between 3 × 7 and 5 × 10 cm. No major complications including total flap failure, hematoma, or infection were observed. However, a partial flap necrosis occurred in 1 patient. In 3 patients, scar revision surgery was performed at the postoperative period. In conclusion, CAPP flap use is a safe and reliable option to repair large nasal defects. This flap is able to cover large nasal defects including dorsal, dome, and nasal sidewall defects in a single-stage procedure. Requiring no pedicle separation, this flap is an alternative option to the conventional median forehead flap.

*Ankara Liv Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey

Washington University School Of Medicine in St. Louis, Department of Plastic Reconstructive and Aesthetic Surgery, St Louis, MO

Ankara Oncology Training and Research Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Ankara, Turkey.

Address correspondence and reprint requests to Yahya Baltu, MD, Address: Department of Plastic Surgery, Ankara Liv Hospital, Ankara, Turkey; E-mail:

Received 22 March, 2019

Accepted 30 April, 2019

The authors report no conflicts of interest.

A part of this paper was presented as oral presentation in the 4th APFSRM Congress on May 9 to 13, 2018 in Antalya, Turkey and in the Plastic Surgery Meeting USA on September 28 to October 1 2018 in Chicago, IL and published in abstract form.

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© 2019 by Mutaz B. Habal, MD.