The Recon Challenge: Rhomboid flap design

We asked for this circular defect to be reconstructed with a rhomboid flap

After some great answers on Twitter & Instagram, here's our schematic and some MedTips.

Enjoy!

1. Draw Lines of Maximum Extensibility (perpendicular to RSTL's)

2. The rhomboid is designed from 2 equilateral triangles, tightly fit to margin of excision. Don't waste precious skin!

3. Recruit skin for the flap from parallel to LME's, where there's greatest laxity.

The challenge is to put it into practice!

2 common modifications are:

1. Dufourmental flap: This does no require 60 and 120 degree angles within the defect. If the defect is constructed from a rhomboid/ parallelogram with smaller angles, similarly, a flap with an acute angle can be transposed into the defect

2. 'Square peg in a round hole': preserves more skin by not making the defect rhomboid & the flap itself is slightly smaller than the defect.

Feel free to drop us a message with any questions or ideas for another Recon challenge!