title: An alternative single-stage application of the paramedian forehead flap in reconstruction of the face.
abstract: BACKGROUND
  Paramedian forehead flap represents a workhorse in facial soft tissue reconstruction but always requires a second step in order to interrupt the skin bridge. Direct visualization and dissection of vascular pedicle may avoid this drawback.
  
  
  METHODS
  Twenty one patients were treated between January 2012 and January 2014: 6 underwent nasal reconstruction and 15 full thickness defect of medial canthus of an orbital region. The follow-up ranges between 6 months and 2 years. All procedures were carried out in a single stage.
  
  
  RESULTS
  All flaps were performed in a single-stage procedure, survived and healed uneventfully.
  
  
  CONCLUSIONS
  The authors describe a refinement of the original technique to be reserved for cases where vessels could be identified by Doppler, consisting in the direct visualization and dissection of the initial tract of the vascular pedicle, thus providing an extremely mobile pedicle whose size allows to locate the first part of the pedicle in the nasion, tunneling under a skin bridge between the emergence of the vessels and the defect.
authors: Department of Plastic and Reconstructive Surgery, CTO Azienda Ospedaliero Universitaria Careggi, Florence, Italy. Electronic address: innocentialessandro@alice.it.
authors: Alessandro
authors: A
authors: Innocenti
authors: Department of Plastic and Reconstructive Surgery, CTO Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors: Marco
authors: M
authors: Innocenti
mesh_terms: D000328:Adult; D000368:Aged; D005145:Face / Q000601:surgery*; D005546:Forehead / Q000601:surgery*; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery; D008875:Middle Aged; D009666:Nose / Q000601:surgery; D009915:Orbit / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D055815:Young Adult
keywords: Axial flap for nose reconstruction; Nose reconstruction; Paramedian forehead flap