A Conceptual Approach to Designing Transposition Flaps. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Scott, Jeffrey F.; Bordeaux, Jeremy S.
• Is Part Of: Dermatologic surgery. Volume 46:Issue 1(2020)
• Publication Date: 2020-01
• Subjects: Skin -- Surgery -- Periodicals; Skin -- Diseases -- Surgery -- Periodicals; 617.477
• DOI: 10.1097/DSS.0000000000002011
• Languages: English
• ISSNs: 1076-0512

Abstract

Abstract : BACKGROUND: The large number of transposition flap geometries available for cutaneous reconstruction often makes the design of these flaps difficult for less experienced dermatologic surgeons. OBJECTIVE: To present a conceptual approach to designing transposition flaps based on 2 elementary angles. MATERIALS AND METHODS: First, a simplified framework for designing transposition flaps is presented, based on: (1) the takeoff point of the flap, (2) the angle between the primary limb and the primary defect (Angle A), and (3) the angle between the secondary limb and the primary limb (Angle B). Next, a comprehensive literature review highlights applications of the above conceptual approach in the design of z-plasties and single-lobed and multi-lobed transposition flaps. RESULTS: Different types of transposition flaps all share the same key design elements, and modifications to Angle A and Angle B predict flap biomechanics. CONCLUSION: The design of transposition flaps can be simplified by understanding how 2 elementary angles influence the geometry and biomechanics of various transposition flaps. Abstract : Supplemental Digital Content is Available in the Text.