title: Design principles for transposition flaps: the rhombic (single-lobed), bilobed, and trilobed flaps.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, Pennsylvania.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Miller
mesh_terms: D001696:Biomechanical Phenomena; D005143:Eyelids / Q000601:surgery*; D006801:Humans; D009666:Nose / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques