Three-dimensional modeling and comparison of nasal flap designs

Adam R. Mattox, Ramona Behshad, Daniel J. Sepe, Eric S. Armbrecht, Ian A. Maher

Research output: Contribution to journalArticle

Abstract

Few studies exist that compare local flap repair designs either mathematically or clinically. Previous mathematical studies use a two-dimensional modeling approach, which is not suited to complex structures like the nose. To quantitatively analyze and compare flap designs for nasal repair using three-dimensional, photographic models. via a three-dimensional imaging system (Vectra M3, Canfield Scientific, Parsippany, NJ, USA), images were captured of actual post-Mohs nasal defects on 12 consecutive patients. Transposition, rotation, and advancement flap designs were designed and assessed based on tissue efficiency (Et = SAwound/(SAwound + SAtrimmed) × 100), suture efficiency (Es = SAwound/Lengthsutured× 100), total area undermined, combined 1° and 2° flap motion efficiency (Efm = SAwound/(SAundermined− (SAwound + SAtrimmed)) × 100), incision efficiency (Ei = SAwound/lengthincision× 100), and undermining efficiency (Eu = SAwound/SAundermined× 100). Rotation flap designs are the most tissue efficient (p < 0.001). Transposition designs are the least suture efficient (p = 0.012) and require less undermining than the corresponding rotation flaps (although not statistically significant). Advancement flaps have the highest flap motion efficiency (p = 0.027). Incision and undermining efficiency is equivalent between all three designs (p = 0.308 and p = 0.158, respectively). While statistically significant differences exist between the flaps studied, the clinical significance is unknown. Consequently, the choice in repair design should be made based on its ability to attain a functionally and aesthetically successful reconstruction.

Original languageEnglish (US)
Pages (from-to)575-579
Number of pages5
JournalArchives of Dermatological Research
Volume312
Issue number8
DOIs
StateAccepted/In press - 2020

Keywords

  • Bilobed
  • Flap
  • Rotation
  • Transposition
  • Trilobed
  • Undermining

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