The poster will describe the applicability of the paramedian forehead flap repair technique for Mohs surgery patients with large, extensive skin cancers on the nose. This technically complex, two-stage procedure rotates skin from the forehead to reconstruct the nose after skin cancer is removed and is employed when the lesion is too large to be repaired by more common methods, such as secondary intention, direct closure, and full thickness skin grafting. The poster will provide a summary of the technique and a description of nursing interventions to optimize patient care.
Information in the poster was compiled by case reviews of patients at the University of Colorado Hospital Mohs Surgery Clinic and by literature review. The author provides direct care to patients before, during, and after paramedian forehead flap repairs and will describe successful nursing interventions based upon evidence-based clinical practice.
Mohs surgery patients undergoing paramedian forehead flap repair benefit from nursing interventions addressing the multidimensional nature of their surgical experience. Patients and their family members/care providers require education about the risks and benefits of this procedure and proper wound care to optimize healing, as well as emotional support and encouragement to aid in coping with the multistaged repair which is temporarily disfiguring. Patients require nursing intervention to optimize pain control during and after surgery and may require professional wound care if the patient is unable or lacks necessary assistance to care for his or her wound at home.
The paramedian forehead flap repair is an appropriate and effective method of nasal reconstruction when Mohs surgery necessitates removal of large areas of the nose. Nursing interventions can significantly improve the surgical experience of patients undergoing this procedure and help their family members to cope and participate in the recovery process.
Mohs surgery nurses improve patient outcomes by delivering creative interventions to patients undergoing paramedian forehead flap repair and their families/care providers. These interventions address anxiety, acute pain, body image disturbance, learning needs, family coping, risk for infection, and risk for bleeding.
Brodland, D. G. (2005). Paramedian forehead flap reconstruction for nasal defects. Dermatologic Surgery, 31, 1046-1052.