Reconstruction of Facial Skin Defects with Flap and Graft Techniques: A Comparative Study

Background: Reconstruction of facial skin defects is challenging. Skin flaps and grafts are well-known techniques for reconstructing these defects. The outcomes of the surgeries can vary depending on the surgical procedures and the patient's characteristics. Objectives: This study aimed to compare the results of reconstructing facial skin defects using skin grafts and flaps in patients referred to Imam Reza Hospital, Birjand, Iran. Methods: This quasi-experimental study was performed on 100 patients with tumors and traumatic lesions in the facial area referred to the plastic surgery service of Imam Reza Hospital, Birjand, Iran. For comparison, the data of 50 patients with skin grafts and 50 patients with flaps who underwent facial skin defect repair surgery were collected. Patients' demographic characteristics were extracted from their hospital records. The final reconstruction results were evaluated based on the presence or absence of aesthetic or functional complications three months after surgery. Results: The mean ages of participants were 64.6 +/- 14.0 and 58.3 +/- 19.1 in the flap and graft groups, respectively. Women comprised 26 (52%) of the flap and 22 (44%) of the graft groups. The mean size of lesions in the graft group was 21.3 +/- 17.3 cm and 4.7 +/- 3.9 cm in the flap group (P=0.001). The frequency of aesthetic and functional complications in the flap group was 13 (26%) and 9 (18%), and in the graft group was 24 (48%) and 15 (30%), respectively. The frequency of aesthetic complications in the flap group was significantly lower than that in the graft group (P=0.023). There was no significant difference between the two groups in terms of the frequency of functional complications (P=0.160). The frequency of disease recurrence was not significantly related to surgical technique (P=0.749). Furthermore, the lesion location had a significant association with the surgical technique (P=0.009); however, the number of surgeries had no significant association with the surgical technique (P=0.389). Conclusion: In general, except for when there is an indication for using a method, the reconstruction of facial skin defects using a skin flap will have better results than a skin graft.