Rotational flap plastic surgery, double

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 10.04.2021

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Synonym(s)

Double rotational displacement; Double rotation flap; O-to-Z plastic; Rotation shift according to Webster

History
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Other synonyms: Bilateral Rotational Flapplasty, Bilateral Rotational Flap (Webster, 1978)

Definition
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Suture flap plastic surgery of the skin in which two counter-rotating flaps serve to cover the defect.

General information
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  • On both sides of a round or oval skin excision, bilateral rotational lobes with broad stems of the lobes are applied through a wide arched incision in opposite directions.
  • The maximum flap tension should be parallel to the skin tension lines. To compensate for the length of two suture lines of unequal length and to avoid dog-ears, laterally offset triangles are excised at the end of the incision lines according to the von Burow technique (see below, transverse flap plastic surgery). After subcutaneous undermining of the incised skin flaps, they are rotated in the opposite direction into the defect. This results in a Z-shaped suture.
  • Indications: Larger defects after tumor excision in skin areas with unfavorable perfusion conditions, e.g. sacrum or lumbar region.

    Notice! The stems of the flap should be wide to prevent flap necrosis.

Literature
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  1. HernĂ¡ndes-Richter J (1967) Plastic skin replacement after resection of malignant tumors. Chir Plast 3: 163-1677
  2. Petres J, Rompel R, Robins P (1996) Dermatologic surgery. Textbook and atlas. Springer, New York Heidelberg
  3. Zoltan J (1977) Atlas of surgical cutting and suturing techniques. Karger, Basel Munich Paris London

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Last updated on: 10.04.2021