Transposition Flap

This flap must be large enough for transfer into a local defect (D). The surrounding skin can be mobilized for primary coverage of the secondary defect (S)

Transposition Flap

Fig. 3.15 Transposition flap a The transposition flap is outlined at a 90° angle to the defect (D). b The flap is swung into the defect, and the secondary defect (S) is closed by advancing the surrounding skin. c Appearance after closure of all defects.

Fig. 3.15 Transposition flap a The transposition flap is outlined at a 90° angle to the defect (D). b The flap is swung into the defect, and the secondary defect (S) is closed by advancing the surrounding skin. c Appearance after closure of all defects.

Fig.3.16a-c Other options for closing the secondary defect.

Fig. 3.17 Other options for transposition and mobilization. a Transposition flap. b Additional skin is excised to allow closure of the secondary defect (S). c Closure.

Fig. 3.17 Other options for transposition and mobilization. a Transposition flap. b Additional skin is excised to allow closure of the secondary defect (S). c Closure.

Fig. 3.18 The surrounding skin is mobilized and advanced in the direction of the arrow. a The transposition flap is too short.

b A back cut is made to lengthen the flap (while preserving an adequate base).

c Closure of all defects.

Fig. 3.18 The surrounding skin is mobilized and advanced in the direction of the arrow. a The transposition flap is too short.

b A back cut is made to lengthen the flap (while preserving an adequate base).

c Closure of all defects.

(Figs. 3.15b, c, 3.16, 3.17). The flap may be swung through an acute angle (Fig. 3.17), a 90° angle, or even more than 90° depending on the mobility of the surrounding skin. If the transposition flap is too short but has a broad enough base, the flap can be lengthened by adding a back-cut (Fig. 3.18). Care is taken that the residual base is still adequate for flap nutrition (Haas 1991; Weerda 1978a). (Figs. 3.15-3.18)

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