title: A novel advancement flap for reconstruction of massive forehead and temple soft-tissue defects.
abstract: OBJECTIVE
  To describe the authors' experience with an extended deep-plane cervicofacial (EDPCF) advancement flap, a modification of the deep-plane cervicofacial flap, for reconstruction of large forehead and temple soft-tissue defects.
  
  
  METHODS
  Case series at a tertiary referral medical center.
  
  
  METHODS
  The charts of 11 consecutive patients who underwent EDPCF flap surgery for reconstruction of forehead and temple skin cancer defects were reviewed for demographics, smoking status, defect size, length of surgery and hospitalization, American Society of Anesthesiologists Physical Status Classification (ASA) grade, and postoperative complications.
  
  
  RESULTS
  All patients had reconstruction of large forehead and temple defects following either primary resection or Mohs micrographic surgery for skin cancer. No skin grafting was required for secondary defects. The average defect size was 52.2 cm(2) . Patient ages averaged 74 years with a median ASA grade of 3. Thirty-six percent of patients admitted to smoking. Average operative time was 100 minutes, with 82% of patients treated on an outpatient basis. There were no complications of ectropion or facial nerve injury encountered. Partial distal flap necrosis occurred in one patient who admitted to smoking and resolved with conservative management.
  
  
  CONCLUSIONS
  The EDCPF flap is a robust flap with a dual arterial supply and both rotation and advancement components. It is ideal in frail patients with good soft-tissue laxity and provides an immediate one-stage reconstruction with ideal skin color, texture, and thickness matches for large forehead and temple defects.
authors: Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, USA. athuang@mcvh-vcu.edu
authors: Andrew Tsao
authors: AT
authors: Huang
authors: George
authors: G
authors: Tarasidis
authors: Joshua Calvin
authors: JC
authors: Yelverton
authors: Alan
authors: A
authors: Burke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005153:Facial Neoplasms / Q000601:surgery*; D005546:Forehead / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015580:Mohs Surgery; D011183:Postoperative Complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000601:surgery*; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps / Q000098:blood supply*