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A Novel Innovation for Surgical Flap Markings Using Projected Stencils

Sayadi, Lohrasb R., M.D.; Chopan, Mustafa, M.D.; Maguire, Kevin, M.D.; Banyard, Derek A., M.D., M.B.A.; Ehret, Zachary, B.S.; Evans, Gregory R. D., M.D.; Widgerow, Alan D., M.D., M.B.B.Ch., M.Med., M.H.S.

Plastic and Reconstructive Surgery: September 2018 - Volume 142 - Issue 3 - p 827–830
doi: 10.1097/PRS.0000000000004708
Plastic Surgery Focus: Ideas and Innovations

Summary: Despite the vast amount of technological advancement seen in the operating room, surgical markings are still drawn as “best estimates” the same way Susruta drew them in the sixth century BC. Many of the flaps used in plastic surgery have precise geometries that are hard to replicate by hand. In this article, the authors describe a novel approach in making surgical markings more accurate by using a pico-projector to project a prefabricated flap, designed on Google Sketchup, as a stencil. Projected and hand-drawn rhomboid and bilobed flaps were tested on cadavers, with both quantitative and qualitative outcomes favoring the projected flaps. This unique concept can not only be used in the operating room but also serve as an educational tool for training plastic and reconstructive surgeons.


Orange, Calif.; Gainesville, Fla.; and Burlington, Vt.

From the Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine; the Department of Plastic Surgery, University of Florida; and the Department of Plastic Surgery and the Larner College of Medicine, University of Vermont.

Received for publication December 6, 2017; accepted March 21, 2018.

Disclosure: The authors have no financial interest to disclose in relation to the content of this article. No funding was received for this article.

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Alan D. Widgerow, M.D., M.B.B.Ch., M.Med., M.H.S., Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, 101 South City Drive, Suite 108a, Building 55, Orange, Calif. 92868,

©2018American Society of Plastic Surgeons