Reconstruction of Facial Soft Tissue Defects in Dark Skin: A Cross-sectional Study

Background: The face acts as a portal for individuals to connect with their surroundings and communicate with others, thus necessitating the preservation of its structural integrity. Facial distortions can arise from numerous causes, predominantly trauma. This article focuses on facial deformities acquired due to various etiologies and the reconstruction techniques utilized while also reflecting on the current landscape of facial surgery in Africa. Methods: This research provides a descriptive retrospective analysis of a multicenter, hospital-based study that focused on the evaluation and reconstruction of acquired facial soft tissue defects in Sudan. The study encompassed patients with facial defects caused by trauma and skin pathology who subsequently received reconstructive surgery. Results: In a study involving 85 patients, the number of women slightly surpassed that of men, accounting for 51.7% and 41.8%, respectively. The cheek was the most affected area, with 29.4%, followed by the eyelid and lip, each 21.2%. A significant 87.5% of the tumors were classified as malignant nonmelanoma skin cancers, specifically basal cell carcinoma and squamous cell carcinoma. The most frequently used flaps included the nasolabial flap (9.4%). Infection was the most common early complication, occurring in 11.7% of cases. Conclusions: Surgical procedures are crucial despite the susceptibility of colored skin to various complications. Operations performed on dark skin are considered safe. When a primary repair is achievable, it is a superior surgical technique, provided that it achieves a satisfactory result. Other techniques can resurface defects, but carry a high risk of complications.