From the rhombic transposition flap toward Z-plasty: An optimized design using the finite element method

Area of Science:

• Biomechanical Engineering
• Plastic Surgery

Background:

• Rhombic transposition flaps are crucial for wound closure.
• Optimizing flap design can improve surgical outcomes and reduce complications.

Purpose of the Study:

• To develop an optimized rhombic transposition flap design using finite element modeling.
• To evaluate the stress and deformation characteristics of the proposed flap compared to existing techniques.

Main Methods:

• A finite element model was developed to simulate wound closure with rhombic flaps.
• Four sets of material parameters were used to account for skin property uncertainties.
• Stress and deformation results were analyzed to assess flap performance.

Main Results:

• The optimized rhombic flap design reduces maximum von Mises stress by 53% compared to the Dufourmentel flap and 43% for a 60° defect compared to the Limberg flap.
• The design ensures maximum compressive principal stress remains within acceptable limits, avoiding dog-ear formation.
• The flap is suitable for rhombic defects ranging from 60° to 90°.

Conclusions:

• The proposed rhombic transposition flap offers an optimized surgical technique for wound closure.
• This design enhances patient outcomes by minimizing stress and preventing complications.
• The flap is easily implemented and adaptable to various defect geometries.