TY - JOUR
T1 - Three-dimensional modeling and comparison of nasal flap designs
AU - Mattox, Adam R.
AU - Behshad, Ramona
AU - Sepe, Daniel J.
AU - Armbrecht, Eric S.
AU - Maher, Ian A.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
KW - Bilobed
KW - Flap
KW - Rotation
KW - Transposition
KW - Trilobed
KW - Undermining
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U2 - 10.1007/s00403-020-02039-4
DO - 10.1007/s00403-020-02039-4
M3 - Article
C2 - 32060616
AN - SCOPUS:85079552889
SN - 0340-3696
VL - 312
SP - 575
EP - 579
JO - Archives of Dermatological Research
JF - Archives of Dermatological Research
IS - 8
ER -