Clinical application of turn-over flap

Kim, Kyung Ho; Bae, Yong Chan; Jeon, Jae Yong; Hwang, So Min

Abstract

To select the method to cover the soft tissue defect, we should take into account of many factors, such as the location of the defect, the depth and length of the defect, the presence of the osteomyelitis, the exposure of nerve, blood vessel and bone, and so on. As a first choice, primary closure or skin graft can be done. However, with the exposure of tendon, bone, blood vessle and nerve, we should consider local flap, muscle flap, fasciocutaneous flap, musculocutaneous flap and free flap to cover the defect. To make matters worse, it can be happened in some cases that these procedures are even impossible due to debilitating general condition, accompanying other diseases or previous operative scar in neighboring tissue. The authors reconstructed the soft tissue defect elevating the neighboring dermal flap or fasciodermal flap in the fashion of -over flap after deepethelialization in 7 cases of total 6 patients. They had soft tissue defect with varying etiologies and skin graft was done both on the recipient and donor sites of turnover flap in all cases except case 4. With the average 1Z.7 months of follow up period, turn-over flap brought satisfactory results in functional and aesthetic aspects without notable complications in donor and recipient sites, though it has a tendency to leave the recipient site somewhat hypertrophied comparing with neighboring no 1 tissue. In conclusion, turnover flap is an useful one-staged operative procedure and it is simple in design and easy in technique. Furthermore, the operative procedure can be done with the advantage of providing safe and thick skin to the area with a remarkable scar in neighboring tissue after multiple operative procedures or to the case in which it is difficult to do the skin graft, local flap or distant flap due to the technical problems.