Double helix flap to close a massive circular soft-tissue defect

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 64; no. 7; pp. 955 - 957
• Main Authors: Preda, Tamara C, Ashford, Bruce G
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.07.2011; Elsevier
• Subjects: Biological and medical sciences; Biopsy, Needle; Carcinoma, Basal Cell - pathology; Carcinoma, Basal Cell - surgery; Circular defect; Female; Follow-Up Studies; Helix; Humans; Immunohistochemistry; Massive BCC; Medical sciences; Middle Aged; Neoplasm Invasiveness - pathology; Neoplasm Staging; Plastic Surgery; Reconstructive Surgical Procedures - methods; Risk Assessment; Rotation flap; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Skin plastic surgery; Skin Transplantation - methods; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps - blood supply; Treatment Outcome; Wound Healing - physiology; Helix; Rotation flap; Circular defect; Massive BCC; Soft tissue defect; Treatment; Surgery
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2010.10.023

Summary The closure of a circular defect resulting from excision of large soft-tissue tumours may pose a considerable surgical challenge. We have described a successful result from the use of modified double helix rotation flaps following resection of a fungating 15-cm interscapular basal cell carcinoma. Our technique necessitated a single operation only. Alternatives considered were split skin grafting, Keystone flap repair or a myocutaneous flap. All modes of repair carry the risk of tension with resultant necrosis and infection. In our case, wound infection did occur, largely due to a heavy pre-operative microbiological burden. This was treated with intra- and postoperative antibiotics and there was no need for subsequent debridement. We propose the double helix flaps as an alternate means to successful local closure of large circular soft-tissue defects.