ISSN Online: 2177-1235 | ISSN Impresso: 1983-5175

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Cartas ao Editor - Ano 2012 - Volume 27 - Número 3

DESIGNING THE RHOMBIC FLAP IN RELATION TO THE LINES OF MAXIMAL EXTENSION

Ricardo Baroudi
Editor-in-chief of the Revista Brasileira de Cirurgia Plástica

Sir,

The article by Alvarez et al.1 aptly highlights the versatility and usefulness of the rhombic flap in various sites and defects. Accurate designing of a rhombic flap pre-operatively is of paramount importance for consistent results. The authors though have described the basic design of a rhombic flap; one important aspect has been under-emphasized. The least tension in the flap is possible only if the short diagonal of the rhombic flap falls in the lines of maximal extensibility (LME). This has been previously famously by Borges2. Such a design minimizes the tension of closure and hence it is important to accurately orient two limbs of the rhombic flap. We can start by marking two lines of the rhombus along the LME. The other two lines are then marked at 60 and 120 degrees (Figure 1).


Figure 1 - Design of a rhombic flap in relation to LME and RSTL. LME = lines of maximal extensibility. RSTL = relaxed skin tension line.



Then the short diagonal of the flap is extended such that it follows the LME. This design however may not be possible for large defects or if the defect is in close proximity to an important aesthetic landmark. As shown by the authors the rhombic flap is a useful tool in the armamentarium of a plastic surgeon.

Sincerely,

Harinatha Sreekar
Senior post-graduate registrar, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, India

Kiran Petkar
Senior post-graduate registrar, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, India

Rahul B. Shetty
Senior post-graduate registrar, Department of Plastic and Reconstructive Surgery, Christian Medical College, Vellore, India

Nithya Raghunath
Post-graduate, Department of Dermatology, MVJ Medical College, Bangalore, India


REFERENCES

1. Alvarez GS, Laitano FF, Siqueira EJ, Oliveira MP, Martins PDE. Use of the rhomboid flap for the repair of cutaneous defects. Rev Bras Cir Plást. 2012;27(1):102-7.

2. Borges AF. The rhombic flap. Plast Reconstr Surg. 1981;67(4):458-66.










Correspondence to:
Harinatha Sreekar
Department of Plastic Surgery, Christian Medical College
Ida Scudder Road
Vellore, India - 632004
E-mail: drsreekarh@yahoo.com

Correspondence submitted to SGP (Sistema de Gestão de Publicações/Manager Publications System) of RBCP (Revista Brasileira de Cirurgia Plástica/Brazilian Journal of Plastic Surgery).
Correspondence received: July 1, 2012
Correspondence accepted: July 7, 2012

 

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