Mechanics of Movement for Rotation Flaps and a Local Flap Template

Department of Plastic Surgery, Loknayak Jaiprakash Narain Hospital.
Plastic &amp Reconstructive Surgery (Impact Factor: 2.99). 05/1989; 83(4):733-7. DOI: 10.1097/00006534-198904000-00024
Source: PubMed


After studying the mechanics of rotational movement, it has become apparent that there exists a local flap template for triangulated defects. Predominant rotation and transposition movements lie at extreme ends of its spectrum. This concept offers a design improvement by which these flaps can be executed with ease and confidence in all areas of the body. Several design variations are available from the template, making the hypothesis versatile and flexible. Underlying this success is the strategic placement of the triangulated defect within an imaginary circle of skin tissue around it. The concept also provides a logical and comprehensive teaching model.

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    ABSTRACT: The rotation design was applied to fasciocutaneous flap repair of lower limb defects to produce a functional and aesthetic result superior to that obtained by the transposition design. A prospective, consecutive series of 21 patients is reported, 14 males and 7 females, ranging in age from 17 to 81 years (mean 43 years). The primary defects, 8 traumatic, 12 cutaneous malignancy excisions, and 1 radionecrotic ulcer, ranged in size from 3.5 x 3 cm to 10 x 8 cm (mean 6.6 x 5 cm). The rotation fasciocutaneous flap base ranged from 5 to 25 cm (mean 12 cm), and the radius ranged from 4.5 to 20 cm (mean 9 cm). The inclusion of a back-cut at the flap base permitted direct donor-site closure in all but one patient, obviating the need for a split-thickness skin graft and avoiding the otherwise inevitable significant contour defect. Postoperative bed rest ranged from 3 to 7 days (mean 5 days). Three minor and no major complications occurred, and there was complete survival of all flaps. The results in this series indicate a role for the rotation fasciocutaneous flap in the management of traumatic and excisional defects in the lower limb. It has proved reliable, gives good aesthetic results, and reduces treatment costs.
    Plastic &amp Reconstructive Surgery 03/1995; 95(2):243-51. DOI:10.1097/00006534-199502000-00003 · 2.99 Impact Factor
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    ABSTRACT: Our goal was to evaluate 2 design properties, pivot point and secondary defect, that affect the results of rotation flaps used to treat skin cancer defects of the head and neck. We conducted a retrospective review of the last 50 patients who underwent rotation flaps for closure of skin cancer defects on the head and neck with regard to postoperative complications. Four patients experienced complications, all of which were managed to an acceptable conclusion. These complications included tip necrosis and ectropion. Rotation flaps, although simple in design, are often modified during their execution. Understanding the basic design and possible modifications of pivot point and secondary defect will yield a successful outcome.
    Journal of Oral and Maxillofacial Surgery 10/2004; 62(9):1069-75. DOI:10.1016/j.joms.2003.12.031 · 1.43 Impact Factor
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    ABSTRACT: Treatment of anal fissures has changed dramatically in the past decade. This is primarily due to a better understanding of its pathophysiology and the implications of the various available options. Only a few anal fissures fail to respond to medical therapy. Sphincterotomy and anal dilatation have fallen out of favour due to the risk of incontinence. Island flaps have been proposed to address this, but 60-70% of the flap donor sites break down with complications. We propose using a rotation flap to overcome this problem. A local rotation flap from perianal skin was used to fill the fissure defect in 14 patients who were followed up for a period of 6 months to determine fissure healing and incidence of donor site breakdown. Twelve patients had complete resolution of their symptoms. Of two patients who developed fissure recurrence, one also had dehiscence of the donor site. There were no donor site complications in the remaining patients. No patient suffered continence defects as a result of the surgery. Rotation flap is a simple, safe and appropriate modality for treating chronic anal fissures. Donor site problems are avoided using this approach. It should be the treatment of choice, particularly in patients who are at risk of incontinence.
    Asian Journal of Surgery 08/2005; 28(3):189-91. DOI:10.1016/S1015-9584(09)60340-7 · 0.91 Impact Factor
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