**8. Summary**

In this article, I am presenting a variety of working models for closure of skin defects of different shapes along with their corresponding indications and mode of use. These working models can be enlarged or reduced in size using a regular copying machine in order to evaluate the best possibilities related to the position of the incision. The great advantage of this method is that the geometrical results are always predictable. Furthermore, this method will improve the survival of the flaps and the cosmetic results.

### **9. Conclusion**

In summary, the surgeon can use a variety of skin incisions taking advantage of the minimal tension lines of the skin and also taking into consideration the

#### **Figure 11.**

*The elongated hexagonal incision is easy to trace and to memorize because it is constructed by using straight lines only. This incision is useful when there is not enough room for extension of the incision at the ends, such as in the case of large skin lesions or sacral ulcers. The skin wastage for this incision is practically null.*

anatomical characteristics of the region involved. For this purpose, the paper models described here can be prepared in advance of the planed surgery to make sure that they adapt to a particular location and according to the elasticity and mobility of the surrounding skin.

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**Author details**

Miami, FL, USA

Alfredo Alvarado1,2,3,4,5

1 Universidad Nacional de Colombia, Bogotá, Colombia

3 International College of Surgery, Chicago, IL, USA

4 Society of Laparoscopic Surgeons, Chicago, IL, USA

provided the original work is properly cited.

5 American College of Emergency Physicians, Irving, TX, USA

\*Address all correspondence to: alfredoalvara@hotmail.com

2 American Board of Surgery and the American Board of Emergency Medicine,

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

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

*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*

anatomical characteristics of the region involved. For this purpose, the paper models described here can be prepared in advance of the planed surgery to make sure that they adapt to a particular location and according to the elasticity and mobility

*The elongated hexagonal incision is easy to trace and to memorize because it is constructed by using straight lines only. This incision is useful when there is not enough room for extension of the incision at the ends, such as* 

*in the case of large skin lesions or sacral ulcers. The skin wastage for this incision is practically null.*

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of the surrounding skin.

**Figure 11.**
