This is a crescentic advancement flap (a Burrow's triangle single tangent advancement flap).
The crescentic advancement flap remains a superior option for defects in the perialar location, an area that is challenging as surgical defects can encompass more than one cosmetic unit (
Yoo et al., Dermatol Surg 2003). There are different ways to visualize and memorize various types of flaps: Two of these methods are included below in
purple and blue:
Burrow’s Triangle Displacement
Flaps (Tissue advancement, requires
extensive undermining, depends on skin laxity and tissue elasticity)
- Burrow’s
flap (Single tangent advancement flap)
- O to T flap
(Bilateral single tangent advancement flap)
- A to T flap
(Bilateral single tangent advancement flap)
- U flap
(Double tangent advancement flap)
- H flap
(Bilateral double tangent advancement flap)
- Curvilinear
tangent advancement flap (Rotation, Karapandzic, Mustarde)
Defect Reconfiguration
Flaps (Island
pedicle flaps, tissue advancement depends on pedicle movement, blood supply
from pedicle)
- Island
pedicle flap (Kite flap, myocutaneous pedicle flap)
Tissue Reorientation Flaps (Reorientation of adjacent skin in
area of laxity)
- Rhombic transposition
flap (Limberg, Dufourmentel, Webster’s)
- Bi-lobed
transposition flap
- Nasolabial
transposition flap (Melolabial fold flap)
- Spear’s flap
Tissue Importation Flaps (Covering large wounds, cover
avascular defects, two stages)
- Paramedian
forehead flap (Indian flap)
- Nasolabial
interpolation flap
- Retroauricular
pedicle flap (Pin back flap)
- Modified
Hughes flap
- Abbe
cross-lip flap
Advancement Flaps (Utilize laxity adjacent to the
wound. Incision made on either side of wound and tissue moved linearly)
- O to T
advancement flap
- A to T
advancement flap
- Island
pedicle advancement flap
- Post
auricular advancement flap
Rotation Flaps (Utilize tissue at a distant site,
which is then rotated and draped over the wound)
- O to Z
- Mustarde
rotation flap
- Back cut
rotation flap
- Spiral
rotation flap
- Dorsal nasal
flap
- Glabella
turndown flap
Transposition Flaps (Move donor tissue over normal tissue
to the site of the defect. All transposition flaps create a secondary defect
which requires closure)
- Z-plasty
transposition flap
- Rhombic
transposition flap
- Paramedian
forehead transposition flap
- Bi-lobed
transposition flap
- Flag
transposition flap
- Banner
transposition flap
Interpolation Flaps (Two-stage flaps in which the base of
the flap is not immediately adjacent to the recipient site. They can tunnel
under or bridge over normal skin)
- Axial
interpolation flap
- Island pedicle flap
Clinical Pearl: A simplified way of looking at flaps is to divide them into advancement, rotation, transposition, and interpolation flaps.
- Advancement flaps: Utilize laxity adjacent to the wound, an incision is made on either side of the wound, and tissue is moved in a linear fashion to cover the defect
- Rotation flaps: Utilize tissue at a distant site, which is then rotated and draped over the wound
- Transposition flaps: Move donor tissue over normal tissue to the site of the defect. All transposition flaps create a secondary defect which requires closure
- Interpolation flaps: Two-stage flaps in which the base of the flap is not immediately adjacent to the recipient site. They can tunnel under or bridge over normal skin.