Rhombic Transposition Flap: Its Modifications and Application in Skin Tumor Surgery

Choi, Kwang Hyun; Kim, Si Yong; Kim, Gyong Moon

Abstract

BACKGROUND
There is currently an increasing demand in the field of dermatology for surgical therapy for treating skin cancers, including premalignant and malignant lesions. The rhombic (often referred to as rhomboid) flap is a transposition flap that is an excellent option for reconstructing small to medium-sized defects after skin surgery.
Objective
We analyzed our clinical results of using the rhombic flap for reconstruction after skin cancers, and especially in regard to the aspects of cosmesis, complete surgical excisions, recurrence and the scope of dermatosurgical care.
METHODS
From July 2004 to May 2008, forty one patients who were diagnosed with non-melanoma skin cancer or benign tumor on the face, trunk and extremities were treated with a rhombic flap or its modified form for the reconstruction of primary cutaneous defects following the excision of tumor. The cases were divided into groups according to the cosmetic units and the clinical outcomes were reviewed, and cosmetic results were scored as excellent, good, fair or poor.
RESULTS
Forty-two rhombic transposition flaps were done in 41 patients. Among these patients, 16 were men and 25 were woman. There were 23 cases of malignant tumor and 19 cases of premalignant and benign tumors. Thirty two cases were located on the face (12 on the cheek, 7 on the nose, 5 on the forehead and periorbital area, 2 on the mouth and 1 on the ear) and 10 cases were located on the other sites (4 on the trunk, 2 on the buttock, 2 on the finger, 1 on the arm and 1 on the leg). There was tumor recurrence in one case. The cosmetic results of reconstructions were satisfactory, and 29 cases out of the 42 (69%) cases showed good to excellent results after 6 months.
CONCLUSION
Rhombic transposition flap can be a simple and good choice for reconstructing cutaneous defects on the face, trunk and extremities after skin tumor surgery. It could also be applied to the defect with limited skin laxity without tension or distortion, and it especially showed excellent and good cosmetic results in most of the cases.