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This single-center retrospective study assessed reconstructive patterns for cheek lesions and created a simple site- and size-based algorithm for small-to medium defects. A total of 129 patients treated between 2022 and 2025 were evaluated; post-excision defect size used the largest clinically measured diameter. Primary closure, local flaps, and skin grafts were compared with statistical tests including ANOVA, Kruskal–Wallis, chi-square, and Spearman correlation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/site-and-size-based-algorithm-for-reconstruction-of-cheek-skin-defects-a-single-center-retrospective-study/461437/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/site-and-size-based-algorithm-for-reconstruction-of-cheek-skin-defects-a-single-center-retrospective-study/461437.png","ImageObject",300,407,{"name":92,"@type":93},"Alexandar","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What reconstruction approach was used after excision in the study?","Question",{"text":112,"@type":113},"Defects were reconstructed with primary closure, local flaps, or skin grafts depending on lesion characteristics and defect size.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the study estimate the post-excision defect size?",{"text":117,"@type":113},"The largest clinically measured lesion diameter was used as a proxy for the post-excision defect size.",{"name":119,"@type":110,"acceptedAnswer":120},"Which factors were identified as key determinants of reconstructive strategy?",{"text":121,"@type":113},"Lesion size and anatomical location were the key determinants, with size thresholds influencing whether primary closure or flap/graft reconstruction was more likely.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461437,1790994789,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090768658,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Article  \nSite-and Size-Based Algorithm for Reconstruction of Cheek Skin Defects: A Single-Center Retrospective Study  \nEmilia Lis 1, Anna Lato 1, Julia Mia´skiewicz 1, Michał Gontarz 2, Tomasz Marecik 2, Krzysztof Ga˛siorowski 2, Grayna Wyszy ´nska-Pawelec 2 and Jakub Bargiel 2, *  \nAcademic Editor: Guy Edward Orchard  \nReceived: 6 December 2025  \nRevised: 27 December 2025  \nAccepted: 30 December 2025  \nPublished: 1 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Students’ Scientific Group, Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-501 Krakow, Poland; [emilia.weronika.lis@gmail.com](emilia.weronika.lis@gmail.com) (E.L.); [anna.lato@student.uj.edu.pl](anna.lato@student.uj.edu.pl) (A.L.); [julia.miaskiewicz@student.uj.edu.pl](julia.miaskiewicz@student.uj.edu.pl) (J.M.)  \n2 Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-501 Krakow, Poland; [tomasz.marecik@uj.edu.pl](tomasz.marecik@uj.edu.pl) (T.M.); [krzysztof.gasiorowski@uj.edu.pl](krzysztof.gasiorowski@uj.edu.pl) (K.G.); [grazyna.wyszynska-pawelec@uj.edu.pl](grazyna.wyszynska-pawelec@uj.edu.pl) (G.W.-P.)  \n* [Correspondence: jakub.bargiel@uj.edu.pl](Correspondence: jakub.bargiel@uj.edu.pl); Tel.: +48-12-400-28-17  \nAbstract  \nBackground: The rising incidence of cutaneous non-melanoma skin cancers underscores the need for individualized reconstruction, particularly for cheek defects that pose distinctive anatomic and functional challenges. This study aimed to analyze reconstructive patterns for cheek skin lesions and to develop a simple, site-and size-based algorithm for small-to medium-sized defects. Methods: We retrospectively reviewed 129 consecutive patients treated between 2022 and 2025 for primary basal cell carcinoma, squamous cell carcinoma, or benign cheek skin tumors. After excision, defects were reconstructed with primary closure, local flaps, or skin grafts. Associations between the largest clinically measured lesion diameter (used as a proxy for the post-excision defect size), anatomical subsite, histopathology, and reconstructive technique were evaluated using ANOVA or Kruskal–Wallis tests, chi-square tests, and Spearman’s correlation. Results: The mean lesion diameter was 19.75 ± 12.93 mm. Reconstruction was performed using local flaps in 62 patients (48.06%), primary closure in 53 (41.09%), and skin grafts in 14 (10.85%) . Larger defects were more frequently managed with grafts or flaps (F(2,110) = 4.84, p = 0.010), and lesion size correlated with reconstructive complexity (Spearman’s ρ = 0.229, p = 0.015) . Lesion location was also significantly associated with the reconstruction method (χ2 (10) = 48.29, p \u003C 0.001; Cramér’s V = 0.44) . Margin-negative (R0) excision was achieved in 95.35% of cases, with a low recurrence rate (3.91%) and complication rate (1.56%) . Conclusions: Lesion size and anatomical location are key determinants of reconstructive strategy for cheek skin defects. In this cohort, lesions ≤ 20 mm were predominantly managed with primary closure, whereas lesions > 20 mm more frequently required flap reconstruction or skin grafting. This size-based split is cohort-derived and should be interpreted as a pragmatic framework that requires external validation.  \nKeywords: non-melanoma skin cancer; basal cell carcinoma; squamous cell carcinoma; cheek; reconstructive surgical procedures; skin grafting; local flaps; treatment algorithm  \n1. Introduction  \nThe human face is a cornerstone of nonverbal communication, and any disruption of its structure can cause profound psychological distress and social impairment [1] . Reconstructive efforts aimed at restoring facial form and function have been documented since  \nantiquity. As surgical techniques have evolved, the pursuit of optimal aesthetic outco","cbCaivgi5W0YKl32","https://ap.wps.com/l/cbCaivgi5W0YKl32","pdf",1415788,18,"English","# Abstract\n# 1. Introduction","[{\"question\":\"What reconstruction approach was used after excision in the study?\",\"answer\":\"Defects were reconstructed with primary closure, local flaps, or skin grafts depending on lesion characteristics and defect size.\"},{\"question\":\"How did the study estimate the post-excision defect size?\",\"answer\":\"The largest clinically measured lesion diameter was used as a proxy for the post-excision defect size.\"},{\"question\":\"Which factors were identified as key determinants of reconstructive strategy?\",\"answer\":\"Lesion size and anatomical location were the key determinants, with size thresholds influencing whether primary closure or flap/graft reconstruction was more likely.\"}]","Site-and Size-Based Algorithm for Reconstruction of Cheek Skin Defects - A Single-Center Retrospective Study | PDF",1790761612,45]