Original Design of the Limberg Flap: An Opposite Triangular Flap.

Abstract

The aim of this study was to identify the original design of the Limberg flap.Publications by the original author, Limberg, and his original designs of the so-called "Limberg flap" were searched in PubMed. These included his original monograph written in Russian (Mathematical Principles of Local Plastic Procedures on the Surface of the Human Body, 1946), the first English paper ("Design of Local Flaps," 1966), and English translation of his book by Wolfe (1984).Three figures that may be the prototypes of the Limberg flap were found in the 1946 Russian monograph. One figure involved designing unilaterally active opposite triangular flaps, placed on a lateral incision on the edge of the defect. Another was closure of a defect of the nasal dorsum with a cheek flap with opposite triangular flaps with lateral incision angles of 30° and 105°. The third depicted closure of the lateral section of a fusiform defect using adjacent opposite triangular patches. In 1966 English chapter, he described the rotation of a triangular flap for the closure of a rhomboid defect. Two standing cones and a lying cone are still formed and should be sited where the tissues are lax enough to compensate. In 1984 English translation, the "unilaterally active opposite triangular flaps" and "rotation of a triangular flap in the closure of a rhomboid defect," were translated as "convergent triangular flaps" and "convergent triangular flaps" respectively.Limberg first called original design of the flap "opposite triangular flap," and later "local triangular flap" for closing rhomboid skin defects.