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2026, Vol: 10, Issue: 9
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Review Article
Online Published: 20 Oct 2026
 


Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts

Mohammed A. Zailai, Osama A. Mobarki, Atlal M. Sayed, Ghufran A. Almowalad, Hussain M. Reda, Faris A. Albariqi, Dalal M. Alatawi, Ragad F. Alzahrani, Maryam S. Khubrani, Rafal H. Daghriri, Duaa A. Faheem, Sarah H. Alwakeel, Alaa H. Hakami.


Abstract
Nasal reconstruction following skin cancer excision remains a complex surgical challenge, with ongoing debate regarding the optimal reconstructive approach. Although local flaps are often favored, comparative evidence remains limited and inconsistently reported. This study aimed to evaluate cosmetic outcomes and complication rates between local flap reconstruction and full-thickness skin grafting (FTSG) in nasal defects. This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420261363919). Studies directly comparing local flaps and FTSG were included. Risk ratios (RR) with 95% confidence intervals were calculated using fixed- and random-effects models. Heterogeneity was assessed using the I² statistic. Four studies met inclusion criteria. Two studies (n = 130) were included in the analysis of cosmetic outcomes. A fixed-effect model favored local flaps (RR = 1.63, 95% CI: 1.28–2.08), whereas this difference was not statistically significant under a random-effects model (RR = 1.63, 95% CI: 0.99–2.69; I² = 70.9%). Two studies (n = 160) assessed complication rates, demonstrating no significant difference between techniques (RR = 0.53, 95% CI: 0.16–1.73; I² = 0%). One study reported patient-reported outcomes, showing comparable satisfaction between groups. Local flaps demonstrated a trend toward improved cosmetic outcomes; however, this advantage was not found to be consistently supported when accounting for inter-study heterogeneity. These findings highlighted a persistent evidence gap in guiding reconstructive decision-making rather than confirming the superiority of a single technique. A defect-driven, individualized approach remains essential in clinical practice.

Key words: Reconstructive choice, nasal defects, systematic review, meta-analysis, local flaps, full-thickness skin grafts


 
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How to Cite this Article
Pubmed Style

Zailai MA, Mobarki OA, Sayed AM, Almowalad GA, Reda HM, Albariqi FA, Alatawi DM, Alzahrani RF, Khubrani MS, Daghriri RH, Faheem DA, Alwakeel SH, Hakami AH. Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. IJMDC. Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100

Web Style

Zailai MA, Mobarki OA, Sayed AM, Almowalad GA, Reda HM, Albariqi FA, Alatawi DM, Alzahrani RF, Khubrani MS, Daghriri RH, Faheem DA, Alwakeel SH, Hakami AH. Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. https://www.ijmdc.com/?mno=333704 [Access: October 20, 2026]. doi:10.24911/IJMDC.51-1788619100

AMA (American Medical Association) Style

Zailai MA, Mobarki OA, Sayed AM, Almowalad GA, Reda HM, Albariqi FA, Alatawi DM, Alzahrani RF, Khubrani MS, Daghriri RH, Faheem DA, Alwakeel SH, Hakami AH. Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. IJMDC. Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100


Vancouver/ICMJE Style

Zailai MA, Mobarki OA, Sayed AM, Almowalad GA, Reda HM, Albariqi FA, Alatawi DM, Alzahrani RF, Khubrani MS, Daghriri RH, Faheem DA, Alwakeel SH, Hakami AH. Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. IJMDC, [cited October 20, 2026]; Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100


Harvard Style

Zailai, M. A., Mobarki, . O. A., Sayed, . A. M., Almowalad, . G. A., Reda, . H. M., Albariqi, . F. A., Alatawi, . D. M., Alzahrani, . R. F., Khubrani, . M. S., Daghriri, . R. H., Faheem, . D. A., Alwakeel, . S. H. & Hakami, . A. H. (2026) Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. IJMDC, Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100


Turabian Style

Zailai, Mohammed A., Osama A. Mobarki, Atlal M. Sayed, Ghufran A. Almowalad, Hussain M. Reda, Faris A. Albariqi, Dalal M. Alatawi, Ragad F. Alzahrani, Maryam S. Khubrani, Rafal H. Daghriri, Duaa A. Faheem, Sarah H. Alwakeel, and Alaa H. Hakami. 2026. Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. International Journal of Medicine in Developing Countries, Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100


Chicago Style

Zailai, Mohammed A., Osama A. Mobarki, Atlal M. Sayed, Ghufran A. Almowalad, Hussain M. Reda, Faris A. Albariqi, Dalal M. Alatawi, Ragad F. Alzahrani, Maryam S. Khubrani, Rafal H. Daghriri, Duaa A. Faheem, Sarah H. Alwakeel, and Alaa H. Hakami. "Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts." International Journal of Medicine in Developing Countries Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100


MLA (The Modern Language Association) Style

Zailai, Mohammed A., Osama A. Mobarki, Atlal M. Sayed, Ghufran A. Almowalad, Hussain M. Reda, Faris A. Albariqi, Dalal M. Alatawi, Ragad F. Alzahrani, Maryam S. Khubrani, Rafal H. Daghriri, Duaa A. Faheem, Sarah H. Alwakeel, and Alaa H. Hakami. "Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts." International Journal of Medicine in Developing Countries Online First: 20 Oct, 2026. Web. 20 Oct 2026 doi:10.24911/IJMDC.51-1788619100


APA (American Psychological Association) Style

Zailai, M. A., Mobarki, . O. A., Sayed, . A. M., Almowalad, . G. A., Reda, . H. M., Albariqi, . F. A., Alatawi, . D. M., Alzahrani, . R. F., Khubrani, . M. S., Daghriri, . R. H., Faheem, . D. A., Alwakeel, . S. H. & Hakami, . A. H. (2026) Reconsidering reconstructive choice in nasal defects: a systematic review and meta-analysis of local flaps versus full-thickness skin grafts. International Journal of Medicine in Developing Countries, Online First: 20 Oct, 2026. doi:10.24911/IJMDC.51-1788619100




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