A conceptual approach to local flaps.

Few procedures offer the surgeon a greater opportunity to exercise his surgical and aesthetic judgement than the design and implementation of local flaps about the head and neck. Considerations include skin color and texture match; adequacy of flap blood supply; size, location, and characteristics of the donor site defect; functional capability of the proposed flap; nature of skin tension lines created; and number of surgical procedures required. A systematic approach to local flap design and implementation is presented, and illustrations of the geometric principles involved are included.