CLOSURE OF NASAL DEFECTS AFTER TUMOR-EXCISION WITH LOCAL FLAPS

There is a myriad of proposals for nasal defect closure. One of the ol der concepts, the so-called topographical concept, adheres to the nasa l subunit principle without taking into consideration textural details of the nasal skin such as thickness and mobility. In a newer concept, a morphological concept, the texture of the nasal skin is a basic con sideration for defect closure. The morphological or textural concept d emands defect closures only with local flaps of nearly identical textu re located within the ''unit'' nose. In order to find out how the morp hological concept influenced our operative design, we carried out a re trospective study from 1988 to 1995 checking the defect closure of all basal cell carcinoma on the nose. Of 598 basal cell carcinoma operate d in the face, 141 were located on the nose. During the first years, f ree skin grafts and regional flaps dominated our operative design, in recent years the use of local flaps according to the criteria of the m orphological concept increased significantly, leading not only to func tional but also to more aesthetic results.