Introduction:

Rhombic flaps are a valuable surgical technique commonly used in plastic and reconstructive surgery for skin defects. This article aims to provide a comprehensive understanding of rhombic flaps, including their principles, indications, surgical procedure, advantages, and potential complications.

Principles of Rhombic Flaps:

Rhombic flaps follow the geometric principle of creating flaps with a rhombus shape. These flaps are designed to allow primary closure in two directions, ensuring optimal wound closure without excessive tension. The unique geometric configuration of rhombic flaps makes them versatile for a wide range of skin defects, including those with irregular shapes or located in areas with limited skin laxity.

Indications:

Rhombic flaps are suitable for a variety of skin defects, such as:

• Surgical excision of skin cancers or tumors
• Traumatic injuries resulting in skin loss
• Chronic wounds that have failed to heal by secondary intention
• Skin defects after scar revision or keloid excision
• Congenital nevi removal

Surgical Procedure:

The surgical procedure for rhombic flaps involves the following steps:

• Preoperative planning: Careful evaluation of the skin defect's size, shape, and location is essential. The surgeon will determine the dimensions of the rhombic flap, considering the length of the sides and the desired angles.
• Flap design: The rhombic flap is marked on the skin, ensuring that the angles are equal and symmetrical. The surgeon will create four triangular flaps with each angle measuring 60 to 120 degrees.
• Dissection and mobilization: The rhombic flap is carefully dissected, preserving the subcutaneous tissue and blood supply. The flap is then mobilized and advanced into the defect, ensuring primary wound closure in two directions.
• Closure: Once the rhombic flap is properly positioned, it is sutured in place, providing adequate coverage for the skin defect.

Advantages:

Rhombic flaps offer several advantages in skin reconstruction:

• Versatility: Rhombic flaps can be tailored to fit various defect shapes and sizes, making them suitable for different anatomical locations.
• Low donor site morbidity: Since rhombic flaps use adjacent skin, there is minimal impact on donor sites.
• Primary wound closure: Rhombic flaps allow for primary closure in two directions, reducing tension on the wound and improving healing outcomes.
• Aesthetic results: The design of rhombic flaps often leads to excellent cosmetic outcomes, with minimal distortion of adjacent structures.

Complications:

While rhombic flaps are generally safe and effective, potential complications may include:

• Flap necrosis: Inadequate blood supply or excessive tension may lead to flap necrosis.
• Scar hypertrophy: Hypertrophic scarring may occur, especially in patients prone to keloid formation.
• Wound dehiscence: Poor wound healing or excessive tension on the closure may result in wound dehiscence.

Conclusion:

Rhombic flaps are a versatile and reliable surgical technique for skin reconstruction in various clinical scenarios. By understanding the principles, indications, surgical procedure, advantages, and potential complications of rhombic flaps, plastic and reconstructive surgeons can employ this valuable tool to achieve optimal outcomes in skin defect reconstruction.

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