Gulati Arushi, Grekin Roy, Neuhaus Isaac, Saylor Drew, Yu Siegrid, Park Andrea, Seth Rahul, Knott P Daniel
Department of Otolaryngology-Head and Neck Surgery and University of California, San Francisco, California, USA.
Department of Dermatology, University of California, San Francisco, California, USA.
Facial Plast Surg Aesthet Med. 2023 Jul-Aug;25(4):344-350. doi: 10.1089/fpsam.2022.0170. Epub 2022 Oct 25.
Aesthetic outcomes of facial reconstruction after skin cancer resection (RSCR) may affect long-term quality of life. : To evaluate postoperative patient perceptions of skin cancer defect reconstruction using patient-reported outcome measures. Patients who underwent RSCR from 2016 to 2021 completed validated FACE-Q scales, including Satisfaction with Facial Appearance (SFA), Scar Appearance, and Appearance-Related Distress (ARD). Scores were scaled 0-100 and compared. Sixty-one respondents completed the survey at a median of 3.0 (interquartile range: 1.6-4.1) years post-treatment. The majority had basal cell carcinomas ( = 41, 67%) and nasal defects ( = 40, 66%). Patients who received either revision surgery or office-based procedures to improve scarring reported lower satisfaction with scar appearance (65.8 ± 31.8 vs. 80.1 ± 20.8, = 0.048). Dissatisfaction with scar appearance was correlated with decreased SFA (mean score: 76.6 ± 24.5; = 0.44, = 0.0004) and greater ARD (mean score: 23.8 ± 24.3; = -0.66, < 0.0001). Younger patients were also more likely to experience ARD ( = -0.54, 95% confidence interval: [-0.96, -0.12, = 0.014). SFA and ARD did not differ by operative factors, including reconstruction type, or single- versus multistage reconstruction. Although overall SFA after RSCR is high, regardless of reconstruction type, decreased satisfaction is correlated to poorer psychosocial function. Younger patients and those requiring revision procedures may be at greatest risk.
皮肤癌切除术后面部重建（RSCR）的美学效果可能会影响长期生活质量。目的：使用患者报告的结局指标评估患者对皮肤癌缺损重建术后的看法。2016年至2021年接受RSCR的患者完成了经过验证的FACE-Q量表，包括对面部外观的满意度（SFA）、疤痕外观和与外观相关的困扰（ARD）。分数范围为0至100并进行比较。61名受访者在治疗后中位时间3.0年（四分位间距：1.6 - 4.1年）完成了调查。大多数患者患有基底细胞癌（n = 41，67%）且存在鼻部缺损（n = 40，66%）。接受修复手术或门诊手术以改善疤痕的患者对疤痕外观的满意度较低（65.8 ± 31.8 vs. 80.1 ± 20.8，P = 0.048）。对疤痕外观的不满与SFA降低相关（平均得分：76.6 ± 24.5；P = 0.44，r = 0.0004）以及更高的ARD相关（平均得分：23.8 ± 24.3；P = -0.66，r < 0.0001）。年轻患者也更有可能经历ARD（P = -0.54，95%置信区间：[-0.96, -0.12]，P = 0.014）。SFA和ARD在手术因素方面没有差异，包括重建类型或单阶段与多阶段重建。尽管无论重建类型如何，RSCR后的总体SFA较高，但满意度降低与较差的心理社会功能相关。年轻患者和那些需要修复手术的患者可能风险最大。
