The application of modified rhomboid flap in repairing facial skin and soft tissue defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Na ,  WEN Huicai , FU Jianhua , HUANG Jinjun , LIAO Huaiwei , TU Jun , LU Yingjie , ZHU Yuan , KUAI Quan

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China;

Corresponding?author：

WEN Huicai, Email: whcjxmc@163.com

Keywords：

Modified rhomboid flap; facial skin defect; wound repair; face

DOI：

10.7507/1002-1892.201810020

Video：

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Objective To explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect.Methods Between January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years (range, 11-72 years). The primary tumor included pigmented nevus in 18 cases, basal cell carcinoma in 4 cases, and squamous cell carcinoma in 1 case. The defect location was nose in 8 cases, cheek in 4 cases, malar in 6 cases, forehead in 2 cases, and upper lip in 3 cases. The defect ranged from 0.8 cm×0.8 cm to 3.9 cm×3.9 cm. According to the location and size of facial tumors, the resection area of square lesions was designed. According to the mobility of surrounding tissues and the direction of dermatoglyphic lines, the rhomboid flaps with an angle of 45–60° was designed to repair the defect by tension-free rotation.Results All the flaps survived and the incision healed by first intension. All patients were followed up 3-15 months (mean, 7.3 months). During follow-up, no tumor reoccurred; the color and texture of the flaps were similar with surrounding tissue. There was no obvious scar hyperplasia, nor traction of adjacent normal tissues, and patients were satisfied with the appearance.Conclusion The application of modified rhomboid flaps in repairing facial skin and soft tissue defects caused by resection of round facial tumor has the advantages of flexible design, simple manipulation, and less trauma.

Citation： HUANG Na, WEN Huicai, FU Jianhua, HUANG Jinjun, LIAO Huaiwei, TU Jun, LU Yingjie, ZHU Yuan, KUAI Quan. The application of modified rhomboid flap in repairing facial skin and soft tissue defect. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 207-211. doi: 10.7507/1002-1892.201810020 Copy

1.	Tama? C, Pintilie CT, At?n?soae IV, et al. Surgical reconstruction of post-tumoral facial defects. Rom J Morphol Embryol, 2018, 59(1): 285-291.
2.	Li G, Mu L, Bi Y, et al. Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection: A retrospective case series. Medicine (Baltimore), 2018, 97(25): e11114.
3.	馬艷, 周曉博, 余文捷, 等. 風箏皮瓣在頭面部惡性腫瘤切除術后修復重建中的應用. 中國美容整形外科雜志, 2018, 29(6): 356-358.
4.	陳健, 李暐. 帶蒂組織瓣在頭頸部腫瘤術后缺損修復重建中的應用研究進展. 中國修復重建外科雜志, 2018, 32(3): 369-376.
5.	曾開達, 姚振晟, 展望. 局部皮瓣在修復面部軟組織缺損中的應用. 中華顯微外科雜志, 2018, 41(5): 509-511.
6.	姚遠鎮, 唐修俊, 王達利, 等. 面動脈穿支螺旋槳皮瓣修復上唇皮膚惡性腫瘤切除后創面. 中國修復重建外科雜志, 2018, 32(2): 210-214.
7.	段宏巖, 劉連成, 于錦利, 等. 改良 Limberg、Dufourmentel 菱形轉移皮瓣成形術治療骶尾部藏毛竇. 中華整形外科雜志, 2012, 28(1): 69-71.
8.	Erta? NM, Kü?ük?elebi A, Bozdo?an N, et al. Treatment of recontracture with the subcutaneous pedicle rhomboid flap. Plast Reconstr Surg, 2006, 117(5): 1590-1598.
9.	Hung MH, Liao CT, Kang CJ, et al. Local rhomboid flap reconstruction for skin defects after excising large parotid gland tumors. J Oral Maxillofac Surg, 2017, 75(1): 225.e1-225.e5.
10.	Imafuku K, Hata H, Yamaguchi Y, et al. Modified Dufourmentel flap, easy to design and tailor to the defect. J Dermatol, 2017, 44(1): 68-70.
11.	吳萌, 俞輝明. 菱形皮瓣在顴面部皮膚基底細胞癌切除術后創面修復中的應用. 臨床皮膚科雜志, 2017, 46(8): 595-597.
12.	Kubo K, Takei H, Matsumoto H, et al. Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report. Oncol Lett, 2017, 14(2): 2347-2352.
13.	徐煒志, 魏霞, 狄青海, 等. 菱形皮瓣聯合負壓引流技術分期修復骶尾部巨大褥瘡. 中華整形外科雜志, 2015, 31(1): 65-66.
14.	姜茂華, 楊孝良, 魏邦敏, 等. 臀上部改良菱形筋膜皮瓣修復骶尾部褥瘡的臨床應用. 中國修復重建外科雜志, 2012, 26(3): 319-321.
15.	N N, Kumar M K, Babu K R, et al. Tandem rhomboid flap repair: a new technique in treatment of extensive pilonidal disease of the natal cleft. J Clin Diagn Res, 2014, 8(9): ND03-4.
16.	Rao JK, Shende KS. Overview of local flaps of the face for reconstruction of cutaneous malignancies: single institutional experience of seventy cases. J Cutan Aesthet Surg, 2016, 9(4): 220-225.
17.	Aydin OE, Tan O, Algan S, et al. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med, 2011, 43(1): 1-8.
18.	Lee KS, Kim JO, Kim NG, et al. A comparison of the local flap and skin graft by location of face in reconstruction after resection of facial skin cancer. Arch Craniofac Surg, 2017, 18(4): 255-260.
19.	Mathew J, Varghese S, Jagadeesh S. The limberg flap for cutaneous defects-a two year experience. Indian J Surg, 2007, 69(5): 184-186.
20.	Liu H, Yu N, Shi J, et al. A new modified S-plasty for skin defect closure. Aesthetic Plast Surg, 2015, 39(1): 100-105.

1. Tama? C, Pintilie CT, At?n?soae IV, et al. Surgical reconstruction of post-tumoral facial defects. Rom J Morphol Embryol, 2018, 59(1): 285-291.
2. Li G, Mu L, Bi Y, et al. Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection: A retrospective case series. Medicine (Baltimore), 2018, 97(25): e11114.
3. 馬艷, 周曉博, 余文捷, 等. 風箏皮瓣在頭面部惡性腫瘤切除術后修復重建中的應用. 中國美容整形外科雜志, 2018, 29(6): 356-358.
4. 陳健, 李暐. 帶蒂組織瓣在頭頸部腫瘤術后缺損修復重建中的應用研究進展. 中國修復重建外科雜志, 2018, 32(3): 369-376.
5. 曾開達, 姚振晟, 展望. 局部皮瓣在修復面部軟組織缺損中的應用. 中華顯微外科雜志, 2018, 41(5): 509-511.
6. 姚遠鎮, 唐修俊, 王達利, 等. 面動脈穿支螺旋槳皮瓣修復上唇皮膚惡性腫瘤切除后創面. 中國修復重建外科雜志, 2018, 32(2): 210-214.
7. 段宏巖, 劉連成, 于錦利, 等. 改良 Limberg、Dufourmentel 菱形轉移皮瓣成形術治療骶尾部藏毛竇. 中華整形外科雜志, 2012, 28(1): 69-71.
8. Erta? NM, Kü?ük?elebi A, Bozdo?an N, et al. Treatment of recontracture with the subcutaneous pedicle rhomboid flap. Plast Reconstr Surg, 2006, 117(5): 1590-1598.
9. Hung MH, Liao CT, Kang CJ, et al. Local rhomboid flap reconstruction for skin defects after excising large parotid gland tumors. J Oral Maxillofac Surg, 2017, 75(1): 225.e1-225.e5.
10. Imafuku K, Hata H, Yamaguchi Y, et al. Modified Dufourmentel flap, easy to design and tailor to the defect. J Dermatol, 2017, 44(1): 68-70.
11. 吳萌, 俞輝明. 菱形皮瓣在顴面部皮膚基底細胞癌切除術后創面修復中的應用. 臨床皮膚科雜志, 2017, 46(8): 595-597.
12. Kubo K, Takei H, Matsumoto H, et al. Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report. Oncol Lett, 2017, 14(2): 2347-2352.
13. 徐煒志, 魏霞, 狄青海, 等. 菱形皮瓣聯合負壓引流技術分期修復骶尾部巨大褥瘡. 中華整形外科雜志, 2015, 31(1): 65-66.
14. 姜茂華, 楊孝良, 魏邦敏, 等. 臀上部改良菱形筋膜皮瓣修復骶尾部褥瘡的臨床應用. 中國修復重建外科雜志, 2012, 26(3): 319-321.
15. N N, Kumar M K, Babu K R, et al. Tandem rhomboid flap repair: a new technique in treatment of extensive pilonidal disease of the natal cleft. J Clin Diagn Res, 2014, 8(9): ND03-4.
16. Rao JK, Shende KS. Overview of local flaps of the face for reconstruction of cutaneous malignancies: single institutional experience of seventy cases. J Cutan Aesthet Surg, 2016, 9(4): 220-225.
17. Aydin OE, Tan O, Algan S, et al. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med, 2011, 43(1): 1-8.
18. Lee KS, Kim JO, Kim NG, et al. A comparison of the local flap and skin graft by location of face in reconstruction after resection of facial skin cancer. Arch Craniofac Surg, 2017, 18(4): 255-260.
19. Mathew J, Varghese S, Jagadeesh S. The limberg flap for cutaneous defects-a two year experience. Indian J Surg, 2007, 69(5): 184-186.
20. Liu H, Yu N, Shi J, et al. A new modified S-plasty for skin defect closure. Aesthetic Plast Surg, 2015, 39(1): 100-105.

Chinese Journal of Reparative and Reconstructive Surgery

The application of modified rhomboid flap in repairing facial skin and soft tissue defect

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