Secondary intention healing as an adjunct to the reconstruction of mid-facial defects

Facial skin cancer has a high incidence during later life. The majority of our patients had been previously treated by a number of different modalities. The recurrence or persistance of their cutaneous neoplasm was often quite extensive and thus required a rather large excision to eradicate the disease. Employment of a number of small operations under local anesthesia in which the patients could return to their home environment provided for a potential reduction in psychological and physical morbidity. The use of delayed healing often allowed reconstruction with a local flap or skin graft that if reconstructed primarily would have necessitated a more extensive operative procedure. Use of local flaps and/or skin grafts avoided excessive blood loss and long periods of immobilization associated with larger regional and distant flaps. Finally the denial of reconstructive surgery because of age should be condemned since fairly small operations in conjunction with delayed wound healing can provide acceptable cosmetic and functional results.