BACKGROUND: Nasal reconstruction in Asian patients is challenging given thicker skin, abundant sebaceous glands, and Fitzpatrick skin types III-V, which increase the risk of hypertrophic scarring and pigmentary alterations. Traditional flaps and grafts frequently result in donor-site morbidity, contour deformities, and color mismatch. Conversely, bilayer artificial dermal substitutes offer a potential alternative. METHODS: This retrospective study included eighteen middle-aged and elderly Chinese patients with nasal skin malignancies (0.5 × 0.5 to 2.3 × 2.6 cm) who underwent standard surgical excision followed by single-stage nasal reconstruction using a bilayer artificial dermis (Lando®). In all cases, intraoperative frozen-section analysis was routinely performed to confirm negative peripheral and deep margins prior to reconstruction. Postoperative management involved routine dressing changes until re-epithelialization. Follow-up was conducted for up to 2 years. RESULTS: All defects healed within a mean of 32.67 ± 6.58 days, without requiring secondary grafting or encountering major complications. Minor complications included one superficial infection managed with increased frequency of local wound dressing changes (Clavien-Dindo grade I) and one case of mild hypertrophic scarring that required no additional intervention (Clavien-Dindo grade I). All patients achieved satisfactory wound healing with acceptable nasal contour, and no tumor recurrence was observed during follow-up. CONCLUSION: Single-stage reconstruction using a bilayer artificial dermal substitute is a simple, safe, and effective option for nasal defect repair in Asian patients. It avoids donor-site harvesting, simplifies postoperative management, and may help reduce overall treatment burden, offering a valuable alternative to traditional reconstructive techniques. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Sun et al. (Tue,) studied this question.