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Design Principles for Transposition Flaps: The Rhombic (Single-Lobed), Bilobed, and Trilobed Flaps

Miller, Christopher J. MD

doi: 10.1097/DSS.0000000000000115
Original Article
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BACKGROUND When tension at a cutaneous defect is too great for primary closure or causes distortion of surrounding anatomy, transposition flaps provide a useful reconstruction option.

OBJECTIVE To review the tissue biomechanics of the rhombic, bilobed, and trilobed transposition flaps.

MATERIALS AND METHODS A systematic evaluation of a cutaneous defect is provided to guide a logical approach to the design and execution of transposition flaps.

RESULTS Applying key principles to the design and execution of transposition flaps results in reliable outcomes.

CONCLUSION Carefully designed and executed rhombic, bilobed, and trilobed transposition flaps provide an excellent reconstruction option when tension at a cutaneous defect is too great for primary closure.

Department of Dermatology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania

Address correspondence and reprint requests to: Christopher J. Miller, MD, Department of Dermatology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Suite 1-330S, Philadelphia, PA 19104, or e-mail: christopher.miller@uphs.upenn.edu

The author has indicated no significant interest with commercial supporters.

© 2014 by the American Society for Dermatologic Surgery, Inc. Published by Lippincott Williams & Wilkins
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