Introduction to flap movement: reconstruction of five similar nasal defects using different flaps.

BACKGROUND There are several options for closure of a given surgical defect after tumor extirpation is confirmed. Flap reconstruction is one of these options. OBJECTIVE The purpose of this article is to introduce the three basic types of flap movement: advancement, rotation, and transposition. METHODS Five similar defects located on the nasal sidewall were repaired, each using a different flap design. RESULTS The optimal flap design for a given defect on a particular patient is based on the answers to a series of questions: Where is the available tissue reservoir? How can tissue be mobilized from the reservoir to cover the defect? How do the resulting tension vectors affect critical structures? Where are the final incision lines? CONCLUSION Many factors must be evaluated before determining a method of reconstruction. Flap reconstruction requires a thorough understanding of anatomy and tissue movement.