Lenticular island pedicle flap.
BACKGROUND
Various modifications of island pedicle flaps have been devised to address difficult reconstructive situations. Nevertheless, currently described designs can have limited applicability in many cases, especially for large defects and defects near free margins.


OBJECTIVE
Our purpose is to describe and illustrate a curvilinear lens-shaped island pedicle flap modification flap called the "lenticular" island pedicle flap (LIPF).


METHODS
Illustrative examples with the descriptive technique and a flap comparison chart are provided for the LIPF.


RESULTS
Conceptually, the LIPF is a hybrid design between a rotation flap and a traditional triangular island pedicle flap (TIPF). The flap fills a void between the designs and applications of the TIPF and the dog-ear rotation flap. As such, the flap reproducibly exhibits simultaneous rotational and translational movement to achieve wound coverage in situations in which neither a rotation flap nor a TIPF would be ideal. The lenticular shape is not incidental but, in fact, maximizes wound coverage by the flap. The lenticular design is often accommodated by a teardrop-shaped wound modification, which facilitates inset of the flap. The benefits of the LIPF include (a) closure of wounds in skin too tight to accommodate a TIPF or a rotation flap, (b) redirection of the closure's tension vector, and (c) an esthetically superior scar line.


CONCLUSIONS
The LIPF modification provides several benefits relative to commonly used flaps that rely primarily on either translational or rotational movement to achieve wound closure.
Cvancara
Joseph L
JL
Department of Dermatology, Deaconess Billings Clinics, Billings, Montana 59107-7000, USA.
Jones
Mark S
MS
Wentzell
J Michael
JM
D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D015580:Mohs Surgery / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps