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Modification of Burow's advancement flap: avoiding the secondary triangle
Nicola A Quatrano1, Faramarz H Samie2
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
JAMA Facial Plastic Surgery
|August 1, 2014
Summary
A modified Burow's advancement flap technique reduces scarring and flap size by eliminating a standing cone. This simple suturing method optimizes cosmetic outcomes for cutaneous surgery defects.
Area of Science:
- Dermatologic surgery
- Plastic surgery
- Cutaneous oncology
Background:
- Burow's advancement flap is a versatile technique for repairing large cutaneous defects near free margins.
- Traditional execution involves two standing cones, increasing scarring and flap size.
- A need exists for techniques minimizing incisions and optimizing cosmetic results.
Purpose of the Study:
- To describe a modified Burow's advancement flap technique.
- To demonstrate a simple suturing method that eliminates one standing cone.
- To optimize cosmesis and minimize scarring in cutaneous defect repair.
Main Methods:
- A novel, reproducible suturing technique is presented.
- The technique eliminates the need for a secondary triangle.
- The "rule of halves" is applied to equalize wound edges of unequal length.
Main Results:
- Successfully repaired five Mohs surgical defects using the modified flap.
- The technique minimized suture lines and reduced overall scarring.
- Repairs were achieved within single cosmetic subunits, enhancing aesthetic outcomes.
Conclusions:
- A simple suturing modification effectively eliminates a standing cone in Burow's advancement flaps.
- This technique minimizes scarring and optimizes cosmetic results for various surgical sites.
- The modified flap allows for efficient repair within a single cosmetic subunit.
