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. 2014 Oct;34(5):327–341.

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© Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/

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Fig. 1. — A second neck submandibular recurrence with skin invasion (A, B) of a cutaneous SCC in a 92-year-old patient, was treated with a revision of the neck dissection and a wide skin excision (C). The large defect (B, C) was closed with a PMMC flap with a large (15 cm major axis) skin paddle (C, E), partially lying beyond the inferior limit of the pectoralis major muscle (C). For this reason a small distal part of the skin paddle (C), not vascularised enough by muscolocutaneous perforators, has undergone partial necrosis (E). Despite the large dimensions of the skin paddle, a primary closure of the donor site was successfully performed without any complication (D).