The application of modified rhomboid flap in repairing facial skin and soft tissue defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANG Na ,  WEN Huicai , FU Jianhua , HUANG Jinjun , LIAO Huaiwei , TU Jun , LU Yingjie , ZHU Yuan , KUAI Quan

Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, Nanchang Jiangxi, 330006, P.R.China;

Corresponding author：

WEN Huicai, Email: whcjxmc@163.com

Keywords：

Modified rhomboid flap; facial skin defect; wound repair; face

DOI：

10.7507/1002-1892.201810020

Video：

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Objective To explore the effectiveness of modified rhomboid flap for repairing facial skin and soft tissue defect.Methods Between January 2016 and May 2018, 23 patients with facial skin and soft defect were repaired by the modified rhomboid flap. There were 10 males and 13 females with the median age of 27 years (range, 11-72 years). The primary tumor included pigmented nevus in 18 cases, basal cell carcinoma in 4 cases, and squamous cell carcinoma in 1 case. The defect location was nose in 8 cases, cheek in 4 cases, malar in 6 cases, forehead in 2 cases, and upper lip in 3 cases. The defect ranged from 0.8 cm×0.8 cm to 3.9 cm×3.9 cm. According to the location and size of facial tumors, the resection area of square lesions was designed. According to the mobility of surrounding tissues and the direction of dermatoglyphic lines, the rhomboid flaps with an angle of 45–60° was designed to repair the defect by tension-free rotation.Results All the flaps survived and the incision healed by first intension. All patients were followed up 3-15 months (mean, 7.3 months). During follow-up, no tumor reoccurred; the color and texture of the flaps were similar with surrounding tissue. There was no obvious scar hyperplasia, nor traction of adjacent normal tissues, and patients were satisfied with the appearance.Conclusion The application of modified rhomboid flaps in repairing facial skin and soft tissue defects caused by resection of round facial tumor has the advantages of flexible design, simple manipulation, and less trauma.

Citation： HUANG Na, WEN Huicai, FU Jianhua, HUANG Jinjun, LIAO Huaiwei, TU Jun, LU Yingjie, ZHU Yuan, KUAI Quan. The application of modified rhomboid flap in repairing facial skin and soft tissue defect. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 207-211. doi: 10.7507/1002-1892.201810020 Copy

1.	Tamaş C, Pintilie CT, Atănăsoae IV, et al. Surgical reconstruction of post-tumoral facial defects. Rom J Morphol Embryol, 2018, 59(1): 285-291.
2.	Li G, Mu L, Bi Y, et al. Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection: A retrospective case series. Medicine (Baltimore), 2018, 97(25): e11114.
3.	马艳, 周晓博, 余文捷, 等. 风筝皮瓣在头面部恶性肿瘤切除术后修复重建中的应用. 中国美容整形外科杂志, 2018, 29(6): 356-358.
4.	陈健, 李暐. 带蒂组织瓣在头颈部肿瘤术后缺损修复重建中的应用研究进展. 中国修复重建外科杂志, 2018, 32(3): 369-376.
5.	曾开达, 姚振晟, 展望. 局部皮瓣在修复面部软组织缺损中的应用. 中华显微外科杂志, 2018, 41(5): 509-511.
6.	姚远镇, 唐修俊, 王达利, 等. 面动脉穿支螺旋桨皮瓣修复上唇皮肤恶性肿瘤切除后创面. 中国修复重建外科杂志, 2018, 32(2): 210-214.
7.	段宏岩, 刘连成, 于锦利, 等. 改良 Limberg、Dufourmentel 菱形转移皮瓣成形术治疗骶尾部藏毛窦. 中华整形外科杂志, 2012, 28(1): 69-71.
8.	Ertaş NM, Küçükçelebi A, Bozdoğan N, et al. Treatment of recontracture with the subcutaneous pedicle rhomboid flap. Plast Reconstr Surg, 2006, 117(5): 1590-1598.
9.	Hung MH, Liao CT, Kang CJ, et al. Local rhomboid flap reconstruction for skin defects after excising large parotid gland tumors. J Oral Maxillofac Surg, 2017, 75(1): 225.e1-225.e5.
10.	Imafuku K, Hata H, Yamaguchi Y, et al. Modified Dufourmentel flap, easy to design and tailor to the defect. J Dermatol, 2017, 44(1): 68-70.
11.	吴萌, 俞辉明. 菱形皮瓣在颧面部皮肤基底细胞癌切除术后创面修复中的应用. 临床皮肤科杂志, 2017, 46(8): 595-597.
12.	Kubo K, Takei H, Matsumoto H, et al. Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report. Oncol Lett, 2017, 14(2): 2347-2352.
13.	徐炜志, 魏霞, 狄青海, 等. 菱形皮瓣联合负压引流技术分期修复骶尾部巨大褥疮. 中华整形外科杂志, 2015, 31(1): 65-66.
14.	姜茂华, 杨孝良, 魏邦敏, 等. 臀上部改良菱形筋膜皮瓣修复骶尾部褥疮的临床应用. 中国修复重建外科杂志, 2012, 26(3): 319-321.
15.	N N, Kumar M K, Babu K R, et al. Tandem rhomboid flap repair: a new technique in treatment of extensive pilonidal disease of the natal cleft. J Clin Diagn Res, 2014, 8(9): ND03-4.
16.	Rao JK, Shende KS. Overview of local flaps of the face for reconstruction of cutaneous malignancies: single institutional experience of seventy cases. J Cutan Aesthet Surg, 2016, 9(4): 220-225.
17.	Aydin OE, Tan O, Algan S, et al. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med, 2011, 43(1): 1-8.
18.	Lee KS, Kim JO, Kim NG, et al. A comparison of the local flap and skin graft by location of face in reconstruction after resection of facial skin cancer. Arch Craniofac Surg, 2017, 18(4): 255-260.
19.	Mathew J, Varghese S, Jagadeesh S. The limberg flap for cutaneous defects-a two year experience. Indian J Surg, 2007, 69(5): 184-186.
20.	Liu H, Yu N, Shi J, et al. A new modified S-plasty for skin defect closure. Aesthetic Plast Surg, 2015, 39(1): 100-105.

1. Tamaş C, Pintilie CT, Atănăsoae IV, et al. Surgical reconstruction of post-tumoral facial defects. Rom J Morphol Embryol, 2018, 59(1): 285-291.
2. Li G, Mu L, Bi Y, et al. Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection: A retrospective case series. Medicine (Baltimore), 2018, 97(25): e11114.
3. 马艳, 周晓博, 余文捷, 等. 风筝皮瓣在头面部恶性肿瘤切除术后修复重建中的应用. 中国美容整形外科杂志, 2018, 29(6): 356-358.
4. 陈健, 李暐. 带蒂组织瓣在头颈部肿瘤术后缺损修复重建中的应用研究进展. 中国修复重建外科杂志, 2018, 32(3): 369-376.
5. 曾开达, 姚振晟, 展望. 局部皮瓣在修复面部软组织缺损中的应用. 中华显微外科杂志, 2018, 41(5): 509-511.
6. 姚远镇, 唐修俊, 王达利, 等. 面动脉穿支螺旋桨皮瓣修复上唇皮肤恶性肿瘤切除后创面. 中国修复重建外科杂志, 2018, 32(2): 210-214.
7. 段宏岩, 刘连成, 于锦利, 等. 改良 Limberg、Dufourmentel 菱形转移皮瓣成形术治疗骶尾部藏毛窦. 中华整形外科杂志, 2012, 28(1): 69-71.
8. Ertaş NM, Küçükçelebi A, Bozdoğan N, et al. Treatment of recontracture with the subcutaneous pedicle rhomboid flap. Plast Reconstr Surg, 2006, 117(5): 1590-1598.
9. Hung MH, Liao CT, Kang CJ, et al. Local rhomboid flap reconstruction for skin defects after excising large parotid gland tumors. J Oral Maxillofac Surg, 2017, 75(1): 225.e1-225.e5.
10. Imafuku K, Hata H, Yamaguchi Y, et al. Modified Dufourmentel flap, easy to design and tailor to the defect. J Dermatol, 2017, 44(1): 68-70.
11. 吴萌, 俞辉明. 菱形皮瓣在颧面部皮肤基底细胞癌切除术后创面修复中的应用. 临床皮肤科杂志, 2017, 46(8): 595-597.
12. Kubo K, Takei H, Matsumoto H, et al. Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report. Oncol Lett, 2017, 14(2): 2347-2352.
13. 徐炜志, 魏霞, 狄青海, 等. 菱形皮瓣联合负压引流技术分期修复骶尾部巨大褥疮. 中华整形外科杂志, 2015, 31(1): 65-66.
14. 姜茂华, 杨孝良, 魏邦敏, 等. 臀上部改良菱形筋膜皮瓣修复骶尾部褥疮的临床应用. 中国修复重建外科杂志, 2012, 26(3): 319-321.
15. N N, Kumar M K, Babu K R, et al. Tandem rhomboid flap repair: a new technique in treatment of extensive pilonidal disease of the natal cleft. J Clin Diagn Res, 2014, 8(9): ND03-4.
16. Rao JK, Shende KS. Overview of local flaps of the face for reconstruction of cutaneous malignancies: single institutional experience of seventy cases. J Cutan Aesthet Surg, 2016, 9(4): 220-225.
17. Aydin OE, Tan O, Algan S, et al. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med, 2011, 43(1): 1-8.
18. Lee KS, Kim JO, Kim NG, et al. A comparison of the local flap and skin graft by location of face in reconstruction after resection of facial skin cancer. Arch Craniofac Surg, 2017, 18(4): 255-260.
19. Mathew J, Varghese S, Jagadeesh S. The limberg flap for cutaneous defects-a two year experience. Indian J Surg, 2007, 69(5): 184-186.
20. Liu H, Yu N, Shi J, et al. A new modified S-plasty for skin defect closure. Aesthetic Plast Surg, 2015, 39(1): 100-105.

Chinese Journal of Reparative and Reconstructive Surgery

The application of modified rhomboid flap in repairing facial skin and soft tissue defect

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