Flaps and Grafts in Dermatologic Surgery

Staged Interpolation Flaps

Interpolation flaps demand exquisite planning and execution. In return, their sophistication offers rich rewards, with a highly vascularized covering that may resurface complex defects, provide tissue bulk, nourish free cartilage grafts (CG), and restore lining or contour as needed. The…

Transposition Flaps

Flap Design and Considerations A transposition flap is a random-pattern flap that borrows skin laxity from an adjacent area to fill a defect in an area with little or no skin laxity and redirects the tension vectors of the closure.…

V-Y Flaps and Island Flaps

Many variables must be considered when examining a surgical defect and considering reconstructive options. The effective restoration of soft tissue contours improves results by reducing the visual impact of the reconstructive scars. Closure options for soft tissue defects include primary…

Rotation Flaps

A rotation flap employs an arciform incision adjacent to an operative wound in order to recruit laxity from multiple directions and redirect flap closure tension. Adjacent tissue laxity assists flap rotation into the primary defect, and the tension vector is…

Advancement Flaps

Flap Design and Considerations Advancement flaps are the oldest and most basic methods of adjacent tissue transfer in cutaneous surgery. They can be thought of as sliding flaps that move along a single vector directly into the surgical defect (…

Second Intention Healing and Primary Closure

Introduction Second intention healing (SIH) and primary closure are the most common and basic strategies to manage wounds after skin cancer removal. SIH is defined as allowing a wound to heal without suturing together the edges. Primary closure refers to…

Basic Principles in Flap Reconstruction

The reconstruction of wounds has long been a challenge to surgeons. Whereas some wounds may be left to heal by second intention or closed in a simple side-to-side linear fashion, others require more complex movement of local or distant tissue…

Anatomy

Introduction A working knowledge of anatomy is essential to perform any of the myriad of procedures in dermatologic surgery. Most surgical skills, even the basic ones, such as scar orientation and level of undermining, are predicated on a basic command…