Innovations in the island pedicle flap for cutaneous facial reconstruction

BACKGROUND. The island pedicle flap is a useful method of reconstruction in dermatologic surgery. Traditionally, the pedicle has been centrally and inferiorly based, with flap movements by rotation or advancement. With innovations, however, the flap is remarkably applicable to a variety of facial defects. OBJECTIVE. Our purpose is to introduce modifications of the island pedicle flap, including (1) single lateral pedicle, (2) transposition, and (3) interpolation movements. METHODS. Modifications of the island pedicle flap were applied in nine cases of cutaneous repair after Mohs micrographic surgery. Patient records and postoperative photographs were reviewed retrospectively. Both patients and other surgeons were asked to assess outcome variables. RESULTS. Patients and physicians judged overall outcome as "excellent" or "good" in 100% and 90.7% of evaluated cases, respectively. CONCLUSIONS. Variations of the island pedicle flap, including (1) single lateral pedicle, (2) transposition, and (3) interpolation movements, are viable options in the reconstruction of facial defects after Mohs micrographic surgery.