Imafuku Keisuke, Hata Hiroo, Yamaguchi Yasuyuki, Inamura Yuka, Kitamura Shinya, Yanagi Teruki, Shimizu Hiroshi
Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Dermatol. 2017 Jan;44(1):68-70. doi: 10.1111/1346-8138.13568. Epub 2016 Sep 7.
How to close skin defects is one of the most important considerations for skin surgeons. Rhomboid flaps are used for many types of skin defect. Such flaps, represented by the Limberg and Dufourmentel flaps, are widely used at any region of the body because they are composed of straight lines and are easy to draw. However, these valuable techniques have the disadvantage of being prone to dog-ears at a particular area of the flap. Therefore, our talented predecessors have modified these flaps in order to resolve the problems. The modified flaps they designed were difficult to draw because the modified designs were curvy and along esthetic lines. It is difficult for trainees to draw these flaps. To address this issue, we have developed newly modified rhomboid flaps that are based on the Dufourmentel flap. This flap is different from the Dufourmentel flap in omitting the top half of the diamond above the circle. Thus, the tension on the skin decreases and dog-ears are less likely to occur. In addition, our flaps are geometric and easily drawn even by novices. We believe our flap will be a promising option for closing skin defects at any site.
如何闭合皮肤缺损是皮肤外科医生最重要的考量之一。菱形皮瓣可用于多种类型的皮肤缺损。以林伯格皮瓣和迪富尔芒泰尔皮瓣为代表的此类皮瓣，因其由直线构成且易于绘制，在身体的任何部位都被广泛应用。然而，这些有价值的技术存在一个缺点，即在皮瓣的特定区域容易出现“狗耳”。因此，我们有才华的前辈对这些皮瓣进行了改良以解决这些问题。他们设计的改良皮瓣由于其改良后的设计是弯曲的且沿着美学线，所以难以绘制。对于实习生来说，绘制这些皮瓣很困难。为了解决这个问题，我们基于迪富尔芒泰尔皮瓣开发了新的改良菱形皮瓣。这种皮瓣与迪富尔芒泰尔皮瓣的不同之处在于省略了圆形上方菱形的上半部分。因此，皮肤的张力降低，“狗耳”出现的可能性更小。此外，我们的皮瓣是几何形状的，即使是新手也很容易绘制。我们相信我们的皮瓣将是闭合任何部位皮肤缺损的一个有前景的选择。
