title: Single-stage defect repair with latissimus dorsi free flap after extensive resection of terebrant ulcer of the head: three case reports.
abstract: Three cases of advanced ulcerating basal cell carcinoma (terebrant ulcer or ulcus terebrans) of the head are reported. Neglected basaliomas had deeply destroyed larger parts of the skull in three women ages 78, 69, and 65 years when the patients were first admitted for treatment. Death due to meningitis, hemorrhage, or brain damage was imminent. Wide resection and coverage by free latissimus dorsi flaps was carried out in single-stage procedures. The latissimus dorsi, a versatile and very reliable free flap with its constant vascular anatomy and long pedicle, is the ideal flap for the coverage of large defects on the head. The donor site can usually be closed primarily, and the functional deficit is acceptable. All three patients recovered completely. Although only palliative resection could be achieved, the procedures could be justified by the increased survival time and gain in quality of life.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Böheimstrasse 37, D-70199 Stuttgart, Germany. tobiaskoeppe@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Koeppe
authors.forename: T
authors.initials: T
authors.lastname: Kuipers
authors.forename: M
authors.initials: M
authors.lastname: Haug
authors.forename: M
authors.initials: M
authors.lastname: Greulich
authors.forename: W
authors.initials: W
authors.lastname: Gubisch
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery; D005148:Facial Dermatoses / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D009132:Muscles / Q000637:transplantation; D012536:Scalp Dermatoses / Q000601:surgery*; D012883:Skin Ulcer / Q000601:surgery*; D013524:Surgical Flaps