The partial-thickness cross-lip flap for correction of postoncologic surgical defects

Purpose: Abbe and Estlander cross-lip flaps have been described and designed as a full-thickness flap to reconstruct a full-thickness excisional defect. Some Mohs surgical excisions and other serial excisions leave partial-thickness defects. This article reviews a series of partial-thickness cross-lip flaps, which included some orbicularis oris muscle in the vermilion region but otherwise was a subcutaneous flap. Patients and Methods: In the last 7 years, 110 patients with lip cancer had their postsurgical defects reconstructed 24 to 72 hours after the resection. In all cases, negative margins were established by histologic evaluation or Mohs micrographic surgery. Twenty of 29 patients had Abbe- and Estlander-(lip-switch) type flaps, which were composed of a musculomucosal pedicle of 1.25 to 1.50 cm and an attached skin/subcutaneous flap trimmed to fit the defect. The remainder had full-thickness lip-switch flaps. Results: There were no vascular complications in either group. Four patients had notching or trapdoor-type bulking, which were revised after 3 to 6 months. Conclusion: The partial-thickness cross-lip flap has the same viability as the full-thickness flap within 1 cm from the inferior border of the mandible.