Abstract
Using skin flaps and grafts is a well-established and reliable method for skin reconstruction in plastic surgery. Although the surgical technique has been used for several decades, the basic principles remain similar. Factors such as skin thickness, color, and texture, the pattern of sun exposure, and adnexal quality should be considered when selecting the appropriate donor site. Objective: Report a double full-thickness dermoepidermal graft as a reconstructive alternative in a comorbid patient instead of using local flaps. Clinical case: 80 years old comorbid male patient with a synchronic (scalp and frontal) morfeiform basal skin cancer who was taken under local anesthesia to perform an oncological resection and a double supraclavicular full-thickness dermoepidermal graft. Satisfactory evolution, well integrated double graft, adequate oncological management and acceptable aesthetic result. Conclusion: Soft tissue reconstruction is performed according to the size and depth of the wound. If the pericranium is viable split-thickness skin grafts can be used for quick and simple reconstruction, but the first choice for reconstruction is usually local scalp tissue. However, in cases like these one, when a comorbid patient can have cardiovascular complications at the operation room, the full-thickness graft under local anesthesia are quickly and less risk reconstructive option. Besides, lateral forehead defects can be managed with a skin graft alone over an intact pericranium. Finally, after 1cm margins resection in a morfeiform basal skin cancer, soft tissue coverage with several options like skin graft are acceptable.