Reconstruction with Burow's Graft After Mohs' Micrographic Surgery of Facial Basal Cell Carcinoma

Song, Margaret; Jung, Do Sang; Seo, Sang Hee; Ko, Hyun Chang; Kim, Moon Bum; Kwon, Kyung Sool; Oh, Chang Keun

Abstract

BACKGROUND
In reconstruction of facial defects, large defects or defects with insufficient skin laxity could pose a challenge. Burow's graft is a modified full-thickness skin graft which utilizes adjacent skin as the donor site.
OBJECTIVE
To describe the surgical technique of Burow's grafts and to report our experience with the postoperative cosmetic outcome.
METHODS
This is a retrospective review of 16 cases of basal cell carcinoma, reconstructed with Burow's grafts after Mohs' micrographic surgery. Burow's graft was performed in surgical defects which were too large for primary closure. Burow's grafts were then placed on the remaining primary defects and sutured. The size of the tumor and postoperative surgical defects, local complications, and cosmetic outcomes were assessed.
RESULTS
The size of primary defects ranged from 0.9 to 3.5 cm (with a mean of 1.98 cm) in greatest diameter. Seven cases were located on the nose, 3 on the cheek, 2 on the ear, 2 on the temple, and one on the eyebrow and lower eyelid. During the follow-up period, partial graft necrosis occurred in 2 patients but there was no evidence of acute bleeding, hematoma, or infection. There was no tumor recurrence and most of the patients showed minimally discernable scarring with satisfactory aesthetic outcomes.
CONCLUSION
Burow's graft could be recognized as a useful reconstructive method in large skin defects and in areas with limited skin laxity. It provides an aesthetically pleasing result, and it is also simple and easy to perform.