Extended posterior auricular artery flap for coverage of a large temporo-parietal defect

We present a case with a large 5×8 cm full-thickness defect in the temporo-parietal region, which was managed with an extended posterior auricular artery-based flap in one stage. The flap was shaped like a 'gandasa' (an axe-like agricultural implement used in Punjab, India). This allowed ample movement of the flap and also permitted a V-Y closure of the donor site. The flap also received additional blood supply from the ipsilateral superior auricular artery.