Double helix flap to close a massive circular soft-tissue defect.
The closure of a circular defect resulting from excision of large soft-tissue tumours may pose a considerable surgical challenge. We have described a successful result from the use of modified double helix rotation flaps following resection of a fungating 15-cm interscapular basal cell carcinoma. Our technique necessitated a single operation only. Alternatives considered were split skin grafting, Keystone flap repair or a myocutaneous flap. All modes of repair carry the risk of tension with resultant necrosis and infection. In our case, wound infection did occur, largely due to a heavy pre-operative microbiological burden. This was treated with intra- and postoperative antibiotics and there was no need for subsequent debridement. We propose the double helix flaps as an alternate means to successful local closure of large circular soft-tissue defects.
Department of Surgery, The Wollongong Hospital, 372 Crown Street, Wollongong NSW 2500, Australia. tpreda1@hotmail.com
Tamara C
TC
Preda
Bruce G
BG
Ashford
D001707:Biopsy, Needle; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology