Fasciocutaneous Flap Side-to-Side V-Y: Fish Flap

The use of fasciocutaneous flaps remain as first election of reconstructive method after remotion of tumors, benign lesions and sequel of traumas.A new designed fasciocutaneous flap according to mechanism V-Y like island flap is described. It has 2 different portions: 1. Superior and 2. Inferior or triangular.Resected area is reconstructed by means of the active or superior part, recruiting perilesional unaffected tissues; safe vascular supply is maintained by means of random pedicle from its inferior or triangular portion.Between 2012 and 2015 were operated in the Division Plastic Surgery at Argerich Hospital of Buenos Aires, 180 patients with benign and maligns lesions and trauma sequels in different body areas; reconstructive surgery was carried out using the flap described in this article.All flaps survived, except 2 which developed partial flap necrosis finally treated by advancement flap coverage. All donor sites were closed primarily with no secondary skin grafting; in the early postoperative period, any flaps showed signs of excessive tension of its margins and failures of arterial vascularization. All flaps achieve adequate reconstruction with excellent aesthetic results; all patients were satisfied with the surgical outcome. All the flaps reached objectives purposed obtaining an acceptable functional and aesthetic restoration.Fasciocutaneous flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscles and close skin. The advantages of "fish" flap included shorter operative time, lesser pedicle trauma, similar color-match and same texture, ample recruitment of both skin and soft tissues around of principal flap and finally it allowed an adequate closure of donor and reconstructed areas.