After administering general anesthesia, prepare the skin around the wound as well as the area where the flap will be created for aseptic surgery, and drape the area.
Draw the rotation skin flap on the skin adjacent to the wound with the leading edge of the flap being one side of the triangular defect. A sterile toothpick dipped in sterile methylene blue or a sterile skin-marking pen can be used for marking. The flap should be large enough to avoid undue tension when sutured in place. (The arrow shows the direction of flap movement.)