A Conceptual Approach to Designing Transposition Flaps

Jeffrey F. Scott, Jeremy S. Bordeaux

Research output: Contribution to journalArticle


BACKGROUND: The large number of transposition flap geometries available for cutaneous reconstruction often makes the design of these flaps difficult for less experienced dermatologic surgeons. OBJECTIVE: To present a conceptual approach to designing transposition flaps based on 2 elementary angles. MATERIALS AND METHODS: First, a simplified framework for designing transposition flaps is presented, based on: (1) the takeoff point of the flap, (2) the angle between the primary limb and the primary defect (Angle A), and (3) the angle between the secondary limb and the primary limb (Angle B). Next, a comprehensive literature review highlights applications of the above conceptual approach in the design of z-plasties and single-lobed and multi-lobed transposition flaps. RESULTS: Different types of transposition flaps all share the same key design elements, and modifications to Angle A and Angle B predict flap biomechanics. CONCLUSION: The design of transposition flaps can be simplified by understanding how 2 elementary angles influence the geometry and biomechanics of various transposition flaps.

Original languageEnglish (US)
Pages (from-to)9-19
Number of pages11
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
Issue number1
StatePublished - Jan 1 2020
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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