Skills Laboratory: Reconstructive surgery techniques, Part 6: Rotation skin flaps

Consider using this surgical technique when there is available skin for wound closure only on one side of a defect.
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May 01, 2010

Rotation skin flaps are ½- to-¾-circle-shaped flaps that are useful in closing triangular skin defects in which skin for closure is only available on one side of the defect.1 For example, a rotation flap could be used to close a triangular defect near an eye, the anus, or the prepuce. Such flaps move by a combination of stretching and rotation.

ADVANTAGES AND DISADVANTAGES
A rotation skin flap provides a nice means of closing a defect in which skin for closure is only available on one side of the lesion or in which direct closure would result in distortion of a body part. However, it does require making a wound to correct a wound. Furthermore, if a large enough flap is not made, tension will be present on the closure site, and distortion of a body part is possible.

If a triangular wound is present near a body part (e.g. nose, tail) and skin is available for closure on both sides of the wound, you can consider performing bilateral rotation flaps. The technique is the same as creating a single rotation flap, but the technique is done on two sides of the wound. Each flap is made to rotate only halfway across the defect, and the straight edges of the two flaps are sutured together.1

POSTOPERATIVE CARE
Place a bandage over the surgical area to prevent wound molestation (or place an Elizabethan collar on the patient). Administer systemic analgesia (e.g. a morphine drip or a fentanyl patch) for a few days after surgery. Change bandages periodically to check the status of the surgical area. Remove the sutures after 14 days.

ACKNOWLEDGMENT
Thank you to Lori Lind, RVT, Gladstone Animal Clinic, Gladstone, Mo., for her assistance during the demonstration.

Steven F. Swaim, DVM, MS
Professor emeritus
Scott-Ritchey Research Center
Department of Clinical Sciences
College of Veterinary Medicine
Auburn University
Auburn University, AL 36849

REFERENCE
1. Swaim SF, Henderson RA. Small animal wound management. 2nd ed. Baltimore, Md.: Williams & Wilkins, 1997;235-274.

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