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Table 1: Site of orofacial defect
Site Frequency
Lip 15
Nose 13
Cheek 9
Eyelid 7
Perimandibular/submandibular region 3

Table 2: Timing of forehead flap division in 19 patients
Time of flap division Number of patients
Less than 16 days -
16-28 days 8
Greater than 28 days 11

Table 3: Complications noted following use of forehead
flap
Complication Frequency
Total flap failure 2
Epidemolysis 1 Figure 2: Etiology of orofacial defect
Infection 4
Tumor recurrence in flap recipient site 2
Tumor occurrence in flap donor site 1

Figure 3: Types of forehead flap used
partial forehead flap was used in the remaining 12 (27.9%) cases
[Figure 3]. Immediate soft tissue reconstruction was performed
in 7 (16.3%) cases and all were secondary to tumor excision.
Figure 1: Age distribution The remaining 36 (83.7%) patients had delayed reconstruction.
Timing of flap division was documented only in 19 (44.2%) of the
RESULTS 43 patients reviewed and this ranged from 20 to 65 days with
a mean of 35.8 ± 11.9 days. Of these, 11 (57.9%) had delayed
A total of 43 patients had orofacial reconstruction using forehead flap division, 8 (42.1%) had conventional flap division. No patient
flap under general anesthesia within the period reviewed and had early division [Table 2]. All flaps were divided under general
this consisted of 31 (72.1%) males and 12 (27.9%) females, giving anesthesia.
a male to female ratio of 2.6:1. Patients’ ages ranged from 4
to 75 years [Figure 1] with a mean of 33.9 ± 16.3 years. The Of the 43 patients reviewed, 23 had documentation on the
aetiology of soft tissue defect was trauma in 24 (55.8%) cases, duration of hospital stay and this ranged from 19 to 146 days with
tumor resection in 13 (30.2%) cases, and infection in 6 (14.0%) a mean of 66.9 ± 31.0 days. Postoperative complications [Table
cases [Figure 2]. Road traffic crashes accounted for 11 (45.8%) 3] was observed in 8 (18.6%) patients and consisted of failed flap
of 24 cases of trauma associated soft tissue defects, while in 2 (25.0%) patients, tumor recurrence in reconstructed site in
malignant tumor excision accounted for 11 (84.6%) of 13 cases 2 (25.0%) patients and tumor occurrence in forehead flap donor
associated with tumor excision. All soft tissue defects arising site in 1 (12.5%) patient.
from orofacial infection were as a result of cancrum oris. When
site of defect is considered, the lip 15 (31.91%) had the highest DISCUSSION
frequency [Table 1].
Axial pattern forehead flaps include both partial (such as median,
Complete forehead flap was used in 31 (72.1%) of cases while para-median and lateral) and complete flaps. These flaps are
Plast Aesthet Res || Volume 3 || April 25, 2016 117