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Nasal Dorsum Rotation-Transposition Flap Associated with Guitar-String Sutures: One-Stage Reconstruction of Large Defects on the Nose

Overview
Journal J Clin Med
Specialty General Medicine
Date 2024 Apr 9
PMID 38592209
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Abstract

(1) : The preferred reconstructive option for closing small- or medium-sized defects of the distal half of the nose is the use of local flaps. The dorsal nasal (Rieger) flap is suitable for closing medium-sized defects at this location, especially when they are medially located, and are wider rather than tall. We describe a rotation-transposition dorsal nasal flap reconstruction for large nasal defects. The novelty of this design includes the addition of a small transposition lobe to the rotation flap, enabling the acquisition of tissue from either the lateral sidewall or the nasolabial sulcus, facilitating closure with guitar-string sutures. (2) : We conducted a retrospective chart review of all the patients with large defects (>20 mm) of the nose who underwent nasal dorsum rotation-transposition flap repair between January 2019 and November 2022 at a single academic center. (3) : Fourteen patients (eight males, six females; ages 47-83, mean age 60 years) with defects (range: 20.00-35.00 mm) on the dorsum and nasal tip were recruited. Follow-up duration ranged from 12 months to 3 years, with all cases showing good or excellent oncologic and cosmetic results. (4) : The rotation-transposition dorsal nasal flap was demonstrated to be a reproducible one-stage technique for large defects of the dorsum and nasal tip, with minimal risk of aesthetic or functional complications. Guitar-string sutures allowed the reduction of the defect size, facilitating a smaller flap design.

References
1.
Zitelli J . The bilobed flap for nasal reconstruction. Arch Dermatol. 1989; 125(7):957-9. View

2.
Dzubow L . The dynamics of flap movement: effect of pivotal restraint on flap rotation and transposition. J Dermatol Surg Oncol. 1987; 13(12):1348-53. DOI: 10.1111/j.1524-4725.1987.tb03581.x. View

3.
Salasche S, Jarchow R, Feldman B, Adnot J . The suspension suture. J Dermatol Surg Oncol. 1987; 13(9):973-8. DOI: 10.1111/j.1524-4725.1987.tb00573.x. View

4.
Redondo P . Guitar-string sutures to reduce a large surgical defect prior to skin grafting or flap movement. Dermatol Surg. 2013; 40(1):69-72. DOI: 10.1111/dsu.12388. View

5.
Zhang A, Meine J . Flaps and grafts reconstruction. Dermatol Clin. 2011; 29(2):217-30, viii. DOI: 10.1016/j.det.2011.02.008. View