Dufourmentel transposition flaps

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 14.04.2021

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Synonym(s)

Dufourmentel sculpture; Rhomboid lobe after Dufourmentel; Transposition flap plastic surgery according to Dufourmentel

History
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Dufourmentel, 1962

Definition
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Transposition near flap of the skin to cover a diamond-shaped defect.

General information
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  • Incision of a triangular skin flap on the long side of the diamond-shaped excision defect. The flap angle close to the defect is 155° and thus 35° more than the similarly cut Limberg transposition flap. The outer cut line of the incision triangle runs at an angle of 60° parallel to the largest diametre of the defect thrombus, and the limb length should be approximately equal in dimension to one side length of the excision rhombus. The length of the outer limb is determined by the tension conditions in the prepared transposition flap, which should be able to be pivoted into the primary defect without tension as far as possible. The flap is undermined and transposed into the defect. A "firehook-shaped" suture is created.
  • Notice. The direction of maximum flap tension (black arrow: Fig. 2 a) should be as perpendicular to the skin tension lines (RSTL) as possible.

  • The Dufourmentel technique is often superior to the Limberg flap in that the maximum flap tension force is distributed over a larger area, which reduces the risk of flap tip necrosis and dog-ear formation.
  • Indications: Smaller tumor excisions in the frontal or temporal region, on the side of the nose, in the zygomatic arch region(Cave! Rr. temporales et Rr. zygomatici of the facial nerve, which run over the arcus zygomaticus just below the subcutaneous fat tissue) (Fig. 1 a-d), at the mandibular angle, preauricular (Fig. 2 a, b, c), larger excisions in the axilla or more rarely at the trunk.

Literature
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  1. Kaufmann R, Podda M, Landes E ( 2005) Dermatological operations. Colour atlas and textbook of skin surgery. Thieme, Stuttgart New York
  2. Petres J, Rompel R, Robins P (1996) Dermatologic surgery. Textbook and atlas. Springer, New York Berlin Heidelberg
  3. Schulz H, Altmeyer P, Stücker M, Hoffmann K (1997) Outpatient operations in dermatology. Hippocrates, Stuttgart

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Last updated on: 14.04.2021