Clinical application of the improved " reading man" procedure flap

Abstract

Objective To evaluate the improved reading-man procedure (RMP) flap for closure of circular skin defect. Methods From January 2011 to June 2014, the improved RMP flap has been used for closure of the circular skin defects in 24 patients (14 men and 10 women) aged from 16 to 83 years. In this technique, the length of the central limb of the improved RMP flap was shorter than one of the RMP flap and the limb of the flap 1 was arc line. Then, the circular defect was closed by transposition of two skin flaps designed in an unequal Z-plasty manner. The first flap (hatchet) was transposed to the defect area whereas the second flap (triangle) was used for closure of the first flap’s donor site. The perforator of the flap provided its vascular basis. Results Tension-free defect closure was obtained in all patients and the all flaps survived. A follow-up of 1-6 months revealed an esthetically acceptable scar formation in all patients. No tumor recurrence occurred, and the repaired tissues were well matched with surrounding tissue. The cosmetic results were satisfactory. Conclusions The improved RMP flap seems to be an easy going and useful alternative for the closure of circular skin defects with different sizes and locations. Key words: Z-plasty; Improved RMP flap; Defect