Relatively deep and complex surgical defects, particularly when adjacent to or involving free margins, present significant reconstructive challenges. When the use of local flaps is precluded by native anatomic restrictions, interpolation flaps may be modified to address these difficult wounds in a single operative session.
To provide a framework to approach difficult soft tissue defects arising near or involving free margins and to demonstrate appropriate design and execution of single-stage interpolation flaps for reconstruction of these wounds.
Examination of our utilization of these flaps based on an anatomic region and surgical approach.
A region-based demonstration of flap conceptualization, design, and execution is provided.
Tunneled, transposed, and deepithelialized variations of single-stage interpolation flaps provide versatile options for reconstruction of a variety of defects encroaching on or involving free margins. The inherently robust vascularity of these flaps supports importation of necessary tissue bulk while allowing aggressive contouring to restore an intricate native topography. Critical flap design allows access to distant tissue reservoirs and placement of favorable incision lines while preserving the inherent advantages of a single operative procedure.
*Department of Dermatology, Stanford University Medical Center, Palo Alto, California;
†Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
Address correspondence and reprint requests to: S. Tyler Hollmig, MD, 50 South Battery, Apt B, Charleston, SC 29401, or e-mail: tylerhollmig@gmail.com
The authors have indicated no significant interest with commercial supporters.
