Bilateral, extended V-Y advancement flap.

Area of Science:

• Plastic Surgery
• Wound Healing
• Reconstructive Surgery

Background:

• Circular skin defects, particularly those from pressure sores, pose reconstructive challenges.
• Standard V-Y advancement flaps may result in significant tension and undesirable midline scars.
• Minimizing tension and scar visibility is crucial for successful reconstruction and patient satisfaction.

Purpose of the Study:

• To present a modified V-Y advancement flap technique for closing circular skin defects.
• To reduce tension during wound closure.
• To avoid a straight midline scar by creating a zigzag closure.

Main Methods:

• A modified technique using bilateral, extended V-Y advancement flaps with additional hinged transpositional limbs was developed.
• The flaps were advanced on a subcutaneous pedicle, with extensions closing the central defect.
• The procedure was applied to 10 patients with sacral and trochanteric pressure sores.

Main Results:

• The modified bilateral, extended V-Y advancement flaps successfully reconstructed large circular defects in all 10 patients.
• No complications or recurrences were observed during a follow-up period of 2 to 10 months.
• The technique effectively minimized tension at the closure site and resulted in a zigzag scar line.

Conclusions:

• Bilateral, extended V-Y advancement flaps offer a viable solution for reconstructing large circular defects.
• This method significantly reduces tension, preventing complications associated with wound closure.
• The resulting zigzag scar is aesthetically preferable to a straight midline scar, enhancing reconstructive outcomes.