Reconstruction of Nasal Defects with Forehead Flaps in Patients Older Than 75 Years of Age

Background: As the number of elderly patients diagnosed with non-melanoma skin cancer (NMSC) increases, the number of patients receiving dermatologic surgery also increases. Multimorbidity in this patient group is common.

Objective: The aim of this study is to assess the aesthetic and functional outcomes and complications of forehead flap (FHF) in elderly patients with NMSC.

Methods: Between 2006 and 2011, data for 28 patients 75 years of age or older who had been treated with FHFs under tumescent local anaesthesia were analysed.

Results: The median age of the study participants was 81 years (range, 75-95 years). Of the 28 total patients, 16 (57%) were female and 12 (43%) were male. The average defect size was 11 cm(2) (5-30 cm(2)). Cartilage grafts were used in four patients (14%). The average time to takedown was 25 days (17-45). The median follow-up for the patients was 10 months (1-60 months). There were seven treatment-related complications due to infectious causes (2), epidermal necrotic tissue (2), bleeding (1), hair on the flap (1) and alar rim notching (1). No life-threatening complications were detected.

Conclusions: The FHF procedure is a safe and low-risk procedure in patients 75 years of age or older with advanced skin defects. If a defect requires an FHF to obtain a normal and aesthetic appearance, this procedure should be performed. However, dermatologists must weigh the safety of the procedure in relation to the clinical benefits when managing this patient group.