Phạm Văn Trung, Nguyễn Đức Thành Nguyễn Đức Tiến

1. APPLICATION OF ANTEROLATERAL THIGH FLAP IN RECONTRACTION LARGE SOFT TISSUE DEFECT AFTER SKIN CANCER SURGERY Phạm Văn Trung, Nguyễn Đức Thành Nguyễn Đức Tiến

2. ABSTRACT • Skincancer consists of 2 primary types: Basal cell carcinoma and Squamous cell carcinoma. • Surgical treatment is the most effective and primary method • The large soft tissue defects after cancer removal is one of the difficulties in plastic surgery • Anterolateral thing flap provides good material to recover the lesions after removal of skin cancer

3. ABSTRACT Study subject ” Application of anterolateral thing flap in recontraction large soft tissue defecs affter skin cancer surgery” aim to : Evaluate the ability of applying the anterolateral thing flap in recontraction large soft tissue defects after skin cancer surgery

4. OVERVIEW • First described in 1984 by Song. R et al. • The flap blood supplied by descending branch of lateral circumflex femoral artery • The maximum size of flap: 35x25 cm

5. Objectsand method • Objects From 1/2012 to 1/2016 in Plastic Surgery Department of Viet Tiep Hospital, Hai Phong, we have performed surgery for 8 patients diagnosed with T1-T4, N0-N1, M0 stage of skin cancer according to the UICC (Union for International Cancer Control). After cutting widenly cancer tissue, we used 8 anterolateral thing flaps to recontract soft tissue defects. The size of the soft tissue ranges from 90 cm2 to 150 cm2. There were 6 free flapsjointed by microsurgery and 2 pedicle flaps.

6. Objects and method 2. Method Evaluate postoperative results: - Good:The flap survived completely, recipient site heals well in 1st intention, donor site heals well - Fair:recipient site heals in 2nd intention - Medium : Partial flap necrosis - Bad: flap necrosis area> 1/3 size, donor site suffers from severe functional complications

7. Results and Discussion Table 3.1. Position of injury

8. Results and Discussion Table 3.2:Form of flap Lê Hồng Phúc, Trần Thiết Sơn ( 2016) : free flap10/12 Cases Phạm Thị Việt Dung, Trần Thiết Sơn (2011) :free flap 65/74 cases

9. Results and Discussion Table 3.3. Flaps size

10. Results and Discussion Table 3.5. Overall results when the patient were discharged from the hospital Lê Hồng Phúc trần Thiết Sơn ( 2016) : Good results 11/12 case

11. CASE ILLUSTRATION Male patient, 69 years old, fungus haematodes on the anterior of the knee Anapathology: squamous cell carcinoma

12. CASE ILLUSTRATION 10 days after surgery Flap Transfer

13. CASE ILLUSTRATION Male patient, 40 years old, Scar ulcer on left heel.

14. CASE ILLUSTRATION 14 days after surgery

15. CASE ILLUSTRATION Male patient, 62 years old, soft tissue defects for 42 years Anapathology: Basal cell carcinoma

16. CASE ILLUSTRATION Nguyen Xuan Th Neurofibromatosis 4th relapse

17. Bui Van Ng 66 years old, Anapathology: Basal cell carcinoma

18. CONCLUSION • Surgical treatment of skin cancer we adhered following by the canonical principle which the tumor cut between 0.5 and 1.5 cm from the edge, using the Mohs technique • Difficulty in recontraction soft tissue defect after cancer • ATF has many advantages in microsurgical flap transfer • The flap satisfied the requirement to recontractsoft tissue defects on the head, face, neck and limbs after cutting the skin cancer.

19. Thank you!