Versatilidade do retalho bilobado

Abstract

BACKGROUND: The bilobed flap is a double transposition flap. Its geometric structure enables a better distribution of tensile forces along its rotation axis, avoiding the skin distortions and redundancy generated by other flaps or primary sutures. The bilobed flap can be made with axial and random vascular patterns, depending on the anatomical region. METHODS: This study reviews 45 surgical cases, describing in detail the technique used to produce the bilobed flap. Defects were classified as small, medium, or large, and several clinical cases are presented in order to explore the versatility of this flap in various etiological diagnoses and anatomical sites. RESULTS: In 93% of the cases, the bilobed flap was used for oncologic reconstructions, and the cephalic segment was affected in 71% of cases. Postoperative complications were absent in 85% of the cases. The rates of infection, trapdoor scar, and epitheliosis and necrosis were 4.4%, 4.4%, and 11.1%, respectively. The overall complication rate was 15%. However, these complications did not compromise the clinical evolution of the cases, and the bilobed flap proved to be resolutive in various situations, providing good functional and aesthetic results. CONCLUSIONS: The bilobed flap is versatile, easy to implement, and is widely used in plastic surgery.