The Ivy loop.

The Ivy loop is a simple, safe, expeditious, multistaged procedure for closing large through-and-through defects of the cheek. It permits three-layered closure with good bulk and minimal deformity at the donor site. A cervical tubed pedicle is migrated into the defect in stages, looping the pedicle around the defect. The loop is then opened eccentrically on its inner rim and closed in layers. The broad-based attachment around the rim of the defect minimizes the danger of tissue loss in irradiated areas. Credit for this procedure must be given to Dr. Robert Ivy. The Ivy loop has its place in selected cases. Two examples are presented.