Application of a subcutaneous tissue pedicle flap combined with a labial mucosa flap for reconstruction of full-thickness lower lip defects: a prospective observational study.

Abstract

Background: Reconstruction of full-thickness lower-lip defects after skin cancer excision is challenging, as both oral function and appearance must be restored. Conventional methods may be insufficient for moderate-sized defects.

Materials and methods: This prospective observational study included 36 patients with T1-T2N0M0 basal or squamous cell carcinoma (SCC) of the lower lip treated between January 2021 and April 2023. Defects involving roughly one-third to two-thirds of the lip were repaired using a combined subcutaneous pedicle flap and labial mucosa flap. Patients were followed for 6-24 months. Functional and aesthetic outcomes, wound healing, scar quality, and recurrence were assessed using standardized scoring systems.

Results: Delayed healing was more common in patients over 70 years (37.5% vs. 5.0%). Defects > 2.0 cm had lower functional scores and higher delayed healing. Moist wound care reduced delayed healing compared with dry healing (exploratory). Tumor recurrence was 10.5% for SCC and 5.8% for BCC. Overall, functional and aesthetic outcomes remained high.

Conclusions: The combined flap technique is a safe, effective option for moderate-sized full-thickness lower-lip defects, providing reliable functional restoration and satisfactory cosmetic results.