Evaluation of bilateral interdigitated Pacman flap for reconstruction of skin defects in different parts of the body

Restorative surgical repair using different surgical modalities is required on the excision of skin lesions or when treating traumatic lacerations; each modality has advantages and drawbacks. In this article, we evaluate the efficacy of using a bilateral interdigitated Pacman flap to reconstruct circular and oval cutaneous defects on different parts of the body. Fourteen patients with soft tissue defects on different parts of the body underwent reconstruction using a bilateral interdigitated Pacman flap. The design of this flap is similar to that of a conventional bilateral V-Y advancement flap; however, the limbs of the V are drawn as slightly curved convex lines. All patients were followed-up for more than 6 months. All soft tissue defects were reconstructed completely using this technique, and no significant complications were noticed except in one patient who developed partial flap necrosis. However, aesthetic issues remain a limiting factor in using this technique. This flap is a reliable, practical and effective option for closure of circular and oval soft tissue defects, although there are certain limitations when used on the face and in younger patients.

Double vest lipodermal flaps for depressed facial scars

INTRODUCTION

Depressed tethered scar is a common problem that can cause emotional, social and behavioural problems, especially when it involves the exposed body parts. Several techniques have been described for treating these depressed scars, but none of these can fulfil the optimal results.

AIM

Evaluating the aesthetic outcome of using a double vest lipodermal flaps for treating depressed facial scars.

MATERIALS AND METHODS

The study included 25 patients with depressed facial scars who underwent scar revision. Their mean age was 31 years. Under local anaesthesia, the scarred area was de-epithelialised and double dart lipodermal flaps were used for revision. Visual analogue and Vancouver scar scales were used as subjective and objective parameters of evaluation, respectively.

RESULTS

All the patients followed up for five to eight months. No complications were observed during the scar healing period. Patients satisfaction according to the visual analogue scale showed an average value of 8. The mean total scale according to the Vancouver scar scale was 2.6.

CONCLUSION

The new technique of using double vest lipodermal flaps is simple and offers a promising alternative for revising depressed scars.