Abstract: Objective To investigate the performance of surgical management in facial skin malignancies. Methods From January 2000 to December 2006, 65 patients with facial skin malignancies, including 47 cases of basal cell carcinoma, 10 cases of squamous cell carcinoma, 3 cases of dermatofibrosarocoma protuberans, 2 cases of malignant melanomas, and one case of malignant acanthoma, hemangioendotheliosarcoma and sebaceous carcinoma, respectively, were collected and managed with wide resection followed by reconstruction. In order to achieve a thorough resection, frozen sections were prepared and subjected to pathological examination during the operation process to ensure the margins of resection were free of malignancy. Reconstruction was carried out by direct closure, or with local random flaps, extended flaps, free skin grafts. Results All defects were managed by one-stage reconstruction. The survival rate of skin flaps/grafts was 100%, and a satisfactory appearance and function was achieved. During the follow-up from 6 months to 5 years, local relapse was observed in one patient with basal cell carcinoma and one with squamous cell carcinoma, lymphatic metastasis in one with squamous cell carcinoma. Distant metastasis occurred in a patient with malignant melanoma, who died consequently. Conclusions Thorough resection is the key to prevent relapse of facial skin malignancies after surgery. Appropriate reconstruction may favor the restoration of facial appearance, and local random flaps appear to be the best reconstruction strategy.

Key words: Face, Skin malignancies, Surgery procedures