Dufourmentel transposition flaps

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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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 incision line of the incision triangle runs parallel to the largest diameter of the defect thrombus at an angle of 60°, whereby the length of the side should correspond to the dimensions of the excision rhombus up to one side length. The length of the outer leg is determined by the tension conditions in the prepared transposition flap, which should be able to be swung into the primary defect with as little tension as possible. The flap is undermined and transposed into the defect. A "fire-hook-shaped" suture is created.
  • Notice! The direction of the maximum flap tension force (black arrow: Fig. 2 a) should be aligned as perpendicular as possible to the skin tension lines (RSTL).

  • The Dufourmentel technique is often superior to the Limberg flap in that the maximum flap tension is distributed over a larger area, which reduces the risk of flap tip necrosis and dog-ear formation.
  • Indications: Smaller tumor excisions in the forehead or temporal region, on the side of the nose, in the zygomatic arch(Cave! Rr. temporales et Rr. zygomatici of the facial nerve, which run above the Arcus zygomaticus just below the subcutaneous fatty tissue) (Fig. 1 a-d), at the mandibular angle, preauricular (Fig. 2 a, b, c), larger excisions in the armpit or, more rarely, on 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: 29.10.2020