BACKGROUND. The optimal design of a skin flap requires an understanding of
the concepts of tissue movement.
OBJECTIVE. The purpose of this manuscript was to demonstrate concepts of sl
iding and lifting tissue movement for flap reconstruction.
METHODS. Six similar defects located in the forehead-temple-eyebrow region
were repaired using a different skin flap.
RESULTS. The specific flap design for a given defect is based on the answer
to three predictable events that result from tissue transfer: Where is the
tension? Where are the final incision lines? Where is the redundant tissue
?
CONCLUSION. A mental exercise assessing all available reconstruction option
s should be performed for each individual patient and defect. Both patient
and defect considerations need to be assessed. A thorough understanding of
both anatomy and tissue movement is necessary for optimal skin flap reconst
ruction.