CHEEK FLAP ISCHEMIC COMPLICATION

HISTORY

70-year-old man with history of sarcoidosis on chronic prednisone. Left preauricular cheek squamous cell carcinoma was treated with Mohs excision and inferior SMAS partial island flap reconstruction. The healing was complicated by wound dehiscence, partially due to wound ischemia and wound tension.

DISCUSSION

The third case represents a dehiscence due to likely ischemia of the leading deep tissue edge. The flap was a fasciocutaneous flap based on blood supply from the SMAS layer. The patient’s comorbidity of sarcoid and chronic prednisone use makes the healing more difficult. As a result dehiscence and likely minor edge ischemia were the probable causes of this patient’s wound separation.