title: Psycho-oncological aspect of surgery in palliative care: our satisfactory experience using a V-Y island flap.
abstract: CONCLUSIONS
  Our reconstruction method using a V-Y island flap was minimally invasive and yielded a satisfactory esthetic result without impairing the patient's postoperative quality of life (QOL).
  
  
  OBJECTIVE
  Malignant skin tumors of the head and neck often affect the patient's appearance and QOL. Therefore, surgery for terminally staged patients with malignant skin tumors may be a treatment of choice for surgeons in a palliative care team to improve and sustain the patient's QOL.
  
  
  METHODS
  We describe our experience of surgical treatment of a large primary malignant skin tumor in the head performed as part of palliative care in a 38-year-old woman in the terminal stage. We developed a V-Y island flap that did not result in postoperative alopecia.
  
  
  RESULTS
  After surgery, the patient did not have alopecia and her hair hid the scar. The patient and her family were greatly satisfied with the result. Although the surgery did not extend her life, it alleviated her depressed condition caused by the uncomfortable primary tumor.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. motomura@med.osaka-cu.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Motomura
authors.forename: Rie
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sakahara
authors.forename: Naho
authors.initials: N
authors.lastname: Fujii
authors.forename: Teruichi
authors.initials: T
authors.lastname: Harada
mesh_terms: D000328:Adult; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D018328:Melanoma, Amelanotic / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D009367:Neoplasm Staging; D010166:Palliative Care / Q000523:psychology*; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology