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Transposition island pedicle flap
Transposition island pedicle flap
This modification of the island pedicle flap, in which the pedicle is transposed at a 30- to 120-degree angle, can be useful in repairs of the medial canthus or lateral nasal ala.27,28 For defects of the medial canthus, the glabellar tissue reservoir is used to create the island, which is transposed into the defect. Closing the secondary defect helps with accurate positioning of the pedicle. For the nasal ala, the transposition island pedicle flap can use the reservoir of tissue in the nasolabial fold to create the pedicle used for
the defect.
This flap has several advantages, including the ability to avoid the standard pivotrelated restraint of transposition flaps, the ability to have the secondary defect not immediately adjacent to the primary defect, the option of using a single-stage flap instead of a two-stage flap, and a superior vascular supply compared to other transposition flaps. The bulkiness of the flap can also be used to the surgeonโs advantage for deep defects in the nasal sidewall or nasal root, or for the recreation of the ala. However, the bulkiness of the flap can also pose as a disadvantage, as it can predispose to trapdooring, result in nasal fullness or protrusion which restricts airflow, and the possibility that stretch and trauma to the pedicle during transposition may cause tip necrosis.