{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:23:42Z","timestamp":1789269822989,"version":"build-2803163510"},"reference-count":17,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Non-melanoma skin cancer (NMSC) takes up a substantial fraction of dermatological and plastic surgical outpatient visits and surgeries. NMSC develops as an accumulated exposure to UV light with the face most frequently diagnosed. Method: This retrospective study investigated the risk of complications in relation to full-thickness skin grafts (FTSG) or local flaps in 607 patients who underwent facial surgery and reconstruction at a high-volume center for facial cancer surgery at a tertiary university hospital. Results: Between 01.12.2017 and 30.11.2020, 304 patients received reconstructive flap surgery and 303 received FTSG following skin cancer removal in the face. Flap reconstruction was predominantly performed in the nasal region (78%, n = 237), whereas FTSG reconstruction was performed in the nasal (41,6%, n = 126), frontal (19.8%, n = 60), and temporal areas (19.8%, n = 60), respectively. Patients undergoing FTSGs had a significantly higher risk of hematoma (p = 0.003), partial necroses (p &lt; 0.001), and total necroses (p &lt; 0.001) compared to flap reconstruction. Age and sex increased the risk of major complications (hematoma, partial or total necrosis, wound dehiscence, or infection) for FTSG, revealing that men exhibited 3.72 times increased risk of major complications compared to women reconstructed with FTSG. A tumor size above 15 mm increased the risk of hematoma and necrosis significantly. In summary, local flaps for facial reconstruction after skin cancer provide lower complication rate compared with FTSGs, especially in elderly and\/or male patients. The indication for FTSG should be considered critically if the patient\u2019s tumor size and location allow for both procedures.<\/jats:p>","DOI":"10.3390\/jpm12122067","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T02:20:57Z","timestamp":1671070857000},"page":"2067","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk Stratification of Local Flaps and Skin Grafting in Skin Cancer-Related Facial Reconstruction: A Retrospective Single-Center Study of 607 Patients"],"prefix":"10.3390","volume":"12","author":[{"given":"Frederik Penzien Wainer","family":"Mamsen","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claes Hannibal","family":"Kiilerich","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Hesselfeldt-Nielsen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iselin","family":"Saltvig","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine Lund-Nielsen","family":"Remvig","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9096-9920","authenticated-orcid":false,"given":"Hannah","family":"Tr\u00f8strup","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker-J\u00fcrgen","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Breast Surgery, Zealand University Hospital (SUH), University of Copenhagen, 4000 Roskilde, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1365-2133.2012.10830.x","article-title":"A systematic review of worldwide incidence of nonmelanoma skin cancer","volume":"166","year":"2012","journal-title":"Br. 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Control"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s10006-008-0139-z","article-title":"Complications after nasal skin repair with local flaps and full-thickness skin grafts and implications of patients\u2019 contentment","volume":"13","author":"Rustemeyer","year":"2009","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"149","DOI":"10.5005\/jp-journals-10001-1281","article-title":"Surgical Planning for Resection and Reconstruction of Facial Cutaneous Malignancies","volume":"7","author":"Erkul","year":"2016","journal-title":"Int. J. Head Neck Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"255","DOI":"10.7181\/acfs.2017.18.4.255","article-title":"A Comparison of the Local Flap and Skin Graft by Location of Face in Reconstruction after Resection of Facial Skin Cancer","volume":"18","author":"Lee","year":"2017","journal-title":"Arch. Craniofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.14730\/aaps.2021.00381","article-title":"Locoregional flaps versus skin grafts in the nose: Aesthetic considerations after cancer ablation","volume":"28","author":"Yoon","year":"2022","journal-title":"Arch. Aesthetic. Plast. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/12\/2067\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:39Z","timestamp":1760146899000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/12\/2067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,15]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jpm12122067"],"URL":"https:\/\/doi.org\/10.3390\/jpm12122067","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,15]]}}}