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On June 28, 1989, at the Fifth International Symposium of Plastic and Reconstructive Surgery of the Head and Neck in Toronto, Canada, Norman A. Orentreich, MD, New York, NY, reported on the usefulness of the skin punch instrument in dermatologic surgery. Small nasal lesions were noted to be ideal indications for excision and reconstruction with the punch. According to Orentreich, the lesion should be marked for orientation prior to its removal, and a biopsy specimen of the base of the lesion should be obtained separately. After histologic confirmation of clear margins, the defect can be reconstructed with a punch graft taken from the medial aspect of the earlobe. Donor skin from this area possesses an excellent tissue match for nasal skin, especially in the lower third of the nose. Additionally, a fair amount of skin can be harvested from the earlobe without creating distortion of the ear. The graft should be
KONIOR RJ. The Punch in Skin Surgery. Arch Otolaryngol Head Neck Surg. 1989;115(12):1415. doi:10.1001/archotol.1989.01860360017007
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