"Pickaxe" double flap: a useful "tool" for reconstruction of deep large medial canthal defects-5-year experience and brief literature review

Reconstruction of large, deep medial canthal defects presents a challenge to reconstructive surgeons, since both safe oncologic excision and aesthetically pleasant results should be met. We report our 5-year experience with the use of a double flap technique, which looks like a "pickaxe", in reconstruction of the aforementioned kind of defects.

The technique is based on the simultaneous use a glabellar and a nasolabial flap designed and raised on either side of the medial canthal defect. The complex of the defect with the flaps looks like a pickaxe. The technique was applied in 17 patients during the last 5 years.

No tumour relapses were recorded in our series (mean follow-up period of 24.8 months). Also neither disfiguring scar contractures nor trapdoor deformities were noticed because of the ample tissue provided and the w-plasty outline of the resulting surgical scar. All patients were satisfied with the aesthetic outcome.

The suggested technique is simple, reliable and provides very good aesthetic results without disfiguring deformities. Most importantly, consistent long-term results with high patient satisfaction and no tumour relapses were achieved.

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