Lenticular Island Pedicle Flap

Abstract

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. Our purpose is to describe and illustrate a curvilinear lens-shaped island pedicle flap modification flap called the "lenticular" island pedicle flap (LIPF). Illustrative examples with the descriptive technique and a flap comparison chart are provided for the LIPF. 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. The LIPF modification provides several benefits relative to commonly used flaps that rely primarily on either translational or rotational movement to achieve wound closure.