Although the scalp represents one of the most visually and anatomically homogeneous regions of the head and neck, its unique anatomic characteristics and subtleties, however, can often make reconstructive surgery in this area quite challenging. The distribution of underlying muscle…
Introduction Skin grafts are autologous portions of skin completely divided from their blood supply and transplanted into a recipient wound. Skin grafts vary in their thickness, composition, and intended purpose, and can be categorized broadly as either full-thickness skin grafts…
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…
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.…
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…
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…
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 (…
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…
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…
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…