A Suture Tips Applied to Rotating Flaps in Reconstructing Facial Defects to Optimize Scarring: A Retrospective Study

Background: Local flap reconstruction is the most common method to repair facial defects. In this study, authors have explored and introduced a modified suture technique with rotation flap to repair facial defects that makes scarring more discreet and easier to perform. Methods: Patients with facial defects who underwent surgical treatment of the rotation flaps reconstructions and were admitted to our department between October 2014 and October 2019 were included in this retrospective study. The rotating flap is designed along the Relaxed Skin Tension Line (RSTLs) and contour lines, parts of patients received modified suture depending on the shape and size of the defect. Observe the flaps’ survival and complications. Assessments of the scars with Vancouver Scar Scale (VSS) regularly and follow-ups. Results: This five-year retrospective study evaluated a total of 56 patients; of these, 45 patients underwent modified suture surgery, the average defects were 19.7±4.5×25.5±5.2mm, and the average duration of follow-up was 13.8±5.0 months. Scar appearance was evaluated using the VSS score, range from 0-5, with an average of 1.6±1.1, and mainly reflected in pigmentation and vascularity. Postsurgical scar concealment is made afterward, and all flaps survive. No hemodynamic disorder or necrosis was found. Conclusion: The rotation flap was designed based on RSTLs/ contour lines to repair the facial defect and make the scarring well concealed. The modified suture method makes the flap line consistent with the RSTLs/ contour line of the facial skin to the maximum extent and leads to better facial aesthetics results.