Design

Authors: Liv Schöllhammer, MD, Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

• Linear pedicle flaps designed non-adjacent to primary defect
• Random or, more common, axil blood supply
• Pedicle is moved under or over intervening tissue
• Usually requires a multistage procedure where the pedicle is cut in the second stage. Pedicle can be cut after a minimum of 3 weeks
• When moved under intervening tissue the pedicle must be de-epithelialized to rest in the subcutaneous tunnel

Paramedian forehead flap

This is a short introduction to one of the earliest described flaps in literature. It requires great technique and experience and a more thorough description can be found elsewhere in the literature. 

• Arterial flap based on the supratrochlear artery
• Classically used in nasal tip reconstruction
• Donor site skin tension may be too great for direct closure with the need for partially healing by secondary intent

Melolabial interpolated flap

• Random flap from cheek (melolabial line)
• Useful in nose reconstruction, especially alar defects
• The width of the flap is equal to the width  of the primary defect
• The flap is raised including a minimum of 3mm subcutaneous fat to ensure vascularity
• The flap can be thinned distally but not proximally on the pedicle to ensure vascularity

Acknowledgements

Illustrations: Marie Helles, med.stud.