**4. Closure of triangular skin defects**

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 jeopardize their survival.

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

#### **Figure 5.**

*The bird's beak incision is very useful in confined regions, where it is important to save sound skin as much as possible, for instance when dealing with lesions near to the orbit or nose. The wastage for this incision is 24%.*

suture lines complies with the principle of reciprocity by which the edges of the skin end up even and without the formation of dog ears. In addition, these incisions have the advantage of producing a short suture line, as compared with the Sakai Soeda and the Mutaf incisions.

As a consequence, this simple method for closure of triangular skin defects could very useful for closure of large meningoceles or when resecting pilonidal sinuses or when removing triangular defects of the face. In the present article, these incisions have been slightly modified in order to produce a better suture line (**Figures 8** and **9**). Besides this, their tracing is easier to memorize, since the base of the triangles are always divided in half instead of dividing in quarters.

## **5. Closure of oval and elongated hexagonal skin defects**

In some occasions, the skin defects take the configuration of an oval (**Figure 10**) or an elongated hexagon (**Figure 11**) which would require considerable extensions at their extremities that in some confined anatomical regions is not feasible.

**109**

practically no wastage of skin.

*skin. The wastage for this incision is 21%.*

**6. Indications**

**Figure 6.**

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

To solve this problem, I am presenting here two new paper models that are easy to trace and to memorize with the advantage of generating a short suture line and with

*The half-moon incision can be used for skin lesions of similar shape and have the advantage of saving sound* 

Any of the incisions described in this article can be selected to accommodate to the characteristics of a particular anatomical region. For instance, the **double S incision** (**Figure 1**) is indicated for closure of multiple small skin defects of the face and other parts of the body. This incision is useful in small defects of the scalp

The **bow tie incision** (**Figure 2**) is very useful when the skin is not quite elastic,

(>1 cm in diameter) and moderate defects of the face (2–3 cm in diameter).

large lesions of the trunk (5–10 cm in diameter).

such as in small defects of the scalp (1–2 cm in diameter), because the waste of sound skin for this incision is 36% only. For the same season, it is very useful in very *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*

suture lines complies with the principle of reciprocity by which the edges of the skin end up even and without the formation of dog ears. In addition, these incisions have the advantage of producing a short suture line, as compared with the Sakai Soeda

*The bird's beak incision is very useful in confined regions, where it is important to save sound skin as much as possible, for instance when dealing with lesions near to the orbit or nose. The wastage for this incision is 24%.*

As a consequence, this simple method for closure of triangular skin defects could very useful for closure of large meningoceles or when resecting pilonidal sinuses or when removing triangular defects of the face. In the present article, these incisions have been slightly modified in order to produce a better suture line (**Figures 8** and **9**). Besides this, their tracing is easier to memorize, since the base of

In some occasions, the skin defects take the configuration of an oval (**Figure 10**)

or an elongated hexagon (**Figure 11**) which would require considerable extensions at their extremities that in some confined anatomical regions is not feasible.

the triangles are always divided in half instead of dividing in quarters.

**5. Closure of oval and elongated hexagonal skin defects**

**108**

and the Mutaf incisions.

**Figure 5.**

#### **Figure 6.**

*The half-moon incision can be used for skin lesions of similar shape and have the advantage of saving sound skin. The wastage for this incision is 21%.*

To solve this problem, I am presenting here two new paper models that are easy to trace and to memorize with the advantage of generating a short suture line and with practically no wastage of skin.
