Patient Satisfaction after Basal Cell Carcinoma (BCC) Excision in Head and Neck Region Followed By Reconstruction with Loco Regional Flaps and Full Thickness Skin Graft

Abstract: Background: Basal cell carcinoma (BCC) is one of the most frequent malignancies and constitutes nearly 80% of the non-melanoma skin malignancies. There is scarcity of local data regarding the patient satisfaction level in the BCC treatment. Objective: To assess patient satisfaction after BCC excision in head & neck region followed by reconstruction with loco regional flaps & full thickness skin grafts (FTSG). Materials and Methods: The present prospective cohort study was performed in Department of Plastic & Reconstructive Surgery Department at Dr. Ruth KM, Pfau, Civil Hospital Karachi, Pakistan during 1st November 2023 to 1st November 2024 after obtaining approval from ethical committee (IRB-3096/DUHS/Approval/2023/420). Post-operatively, patient satisfaction was assessed using four key aspects: skin color, tissue coordination, scar appearance, and skin texture. Each aspect is scored on a scale of 1 to 5, with 1 indicating "Extremely Dissatisfied" and 5 indicating "Extremely Satisfied. Total satisfaction score was calculated by summing four categories and total score of ≥14 was considered as greater patient satisfaction. Results: Total 215 patients were enrolled into the study with mean age of 50.4 ± 10.0 years. More than half of the patients were males (68.4%) and having lesion of nose (51.6%). Mean lesion size was 1.6 ± 0.6 cm. Half of the patients underwent FTSG reconstruction (50.2%). Satisfaction related to skin color (4.2±0.8 vs 3.2±0.8, p<0.001), skin tissue (3.5±0.9 vs 3.3±0.8, p=0.009) and scarring (3.9±0.7 vs 3.6±0.6, p<0.001) were higher in patients underwent local flap reconstruction than FTSG. Conclusion: The present study demonstrated that post-BCC excisional defects reconstruction in head and neck region using local-regional flap brings out higher satisfaction level among patients in comparison to full thickness skin graft. Keywords: Basal cell carcinoma, Plastic & reconstructive surgery, Local flap, Full thickness skin graft, Tumors, Patient satisfaction.