Design Principles for Transposition Flaps: The Rhombic (Single-Lobed), Bilobed, and Trilobed Flaps

BACKGROUND When tension at a cutaneous defect is too great for primary closure or causes distortion of surrounding anatomy, transposition flaps provide a useful reconstruction option. OBJECTIVE To review the tissue biomechanics of the rhombic, bilobed, and trilobed transposition flaps. MATERIALS AND METHODS A systematic evaluation of a cutaneous defect is provided to guide a logical approach to the design and execution of transposition flaps. RESULTS Applying key principles to the design and execution of transposition flaps results in reliable outcomes. CONCLUSION Carefully designed and executed rhombic, bilobed, and trilobed transposition flaps provide an excellent reconstruction option when tension at a cutaneous defect is too great for primary closure.

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