**3. Closure of semicircular skin defects**

For semicircular skin defects, two incisions were described, the *half-moon* (**Figure 6**) and the *goblet* (**Figure 7**) incisions. The first one was especially designed for closure of semicircular defects, and the second one for closure of robust semicircular defects. Both incisions do not have a basic extension but have a complementary extension at the curved side of the incision. The axis of the incisions (axis X-X) follows the minimal tension lines and is centered at the upper corner of the incision. The calculated wastage for the cat's ear incision is 41 and 24% for the bird's beak incision which is in contrast to the wastage of 21% for the half-moon incision and 19% for the goblet incision. All of these configurations are much better as compared with the ellipsoid incision that has a wastage of 156% [6]. One advantage of the goblet incision is that it is more versatile because it has two options for the rotation of the flaps.

**107**

**Figure 4.**

dize their survival.

*Designing Flaps for Closure of a Variety of Skin Defects DOI: http://dx.doi.org/10.5772/intechopen.89547*

**4. Closure of triangular skin defects**

*tension lines of the skin. The wastage of skin for this incision is 41%.*

Most of times, skin lesions have a round shape; but in certain cases, the lesions could present themselves in a triangular shape. In the recent medical literature, there are few methods that can be used for closure of triangular skin defects such as the L-shaped flap for triangular skin defects of Sakai and Soeda [9] and the Mutaf triangular closure [10], or the triangular excision for small lesions of Filho and colleagues [11]. The tracing of the first two incisions is rather complicated and the resultant flaps have a narrow base that could jeopar-

*The cat's ear incision is very useful for skin lesions of the face, where the suture line has to follow the minimal* 

It is for these reasons that I published a "Simple method for closure of triangular skin defects" [12] in 2016. These incisions are easy to trace and to memorize, and more important, they are provided with wide base flaps. Furthermore, the resultant suture lines are away from the central area of the incision and the edges of the

*Designing Flaps for Closure of a Variety of Skin Defects DOI: http://dx.doi.org/10.5772/intechopen.89547*

*Trauma and Emergency Surgery - The Role of Damage Control Surgery*

**106**

**Figure 3.**

*of sound skin is null.*

**3. Closure of semicircular skin defects**

For semicircular skin defects, two incisions were described, the *half-moon* (**Figure 6**) and the *goblet* (**Figure 7**) incisions. The first one was especially designed for closure of semicircular defects, and the second one for closure of robust semicircular defects. Both incisions do not have a basic extension but have a complementary extension at the curved side of the incision. The axis of the incisions (axis X-X) follows the minimal tension lines and is centered at the upper corner of the incision. The calculated wastage for the cat's ear incision is 41 and 24% for the bird's beak incision which is in contrast to the wastage of 21% for the half-moon incision and 19% for the goblet incision. All of these configurations are much better as compared with the ellipsoid incision that has a wastage of 156% [6]. One advantage of the goblet incision is that it is more versatile because it has two options for the rotation of the flaps.

*The combined V incision is other reciprocal incision that is very useful when trying to save sound skin, since the wastage of the skin is reduced to 0%. It could be very useful for removal of large skin lesions because the wastage* 

#### **Figure 4.**

*The cat's ear incision is very useful for skin lesions of the face, where the suture line has to follow the minimal tension lines of the skin. The wastage of skin for this incision is 41%.*
