Local Flap Techniques for Reconstruction of Large Truncal and Extremity Defects

Large cutaneous defects of the trunk and extremities are frequently encountered in dermatologic surgery and often exceed the limits of primary closure. Local flaps remain a strong reconstructive option because of their robust perfusion, excellent skin match, and ability to be performed under local anesthesia in the office setting.

This experience-based narrative overview outlines the authors' preferred local flap techniques for the reconstruction of large truncal and extremity defects. Each approach is illustrated with representative cases.

In our experience, local flaps provide dependable coverage for large truncal and extremity wounds while maintaining natural contour and mobility. Depending on anatomic site and defect characteristics, preferred options include A-T advancement, single- and double-arm (O-Z) rotation flaps, rhombic flaps, keystone flaps, and peri-areolar mobilization techniques.

Local flaps remain versatile options for closure of large truncal and extremity defects.