Coverage of residual defects by using previous flaps: Flip flap puzzle flap

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Wound Healing

Background:

• Terminal flap necrosis and retraction pose significant surgical challenges.
• Limited local tissue availability complicates defect coverage.
• The flip flap puzzle flap is explored as a reconstructive option.

Purpose of the Study:

• To evaluate the efficacy of the flip flap puzzle flap for covering small defects.
• To assess the outcomes of using a previously harvested flap for reconstruction.
• To determine the morbidity associated with this reconstructive technique.

Main Methods:

• The flip flap puzzle flap is harvested from a prior flap at the sub-dermal level.
• The flap is transposed 180° to cover the defect.
• Residual areas are reconstructed using split-skin grafts.

Main Results:

• A prospective study included 10 patients.
• Nine flaps (90%) survived, with one flap failure.
• Partial graft failure occurred in 70% of cases, but all defects achieved eventual healing.

Conclusions:

• The flip flap puzzle flap is a less morbid and rapid method for small defect coverage.
• This technique eliminates donor site morbidity by utilizing existing flaps.
• Successful defect healing was achieved in the majority of patients.