Limberg flap revisited: for closure of facial soft tissue defects

Authors

DOI:

https://doi.org/10.18203/2349-2902.isj20231067

Keywords:

Limberg, Rhomboid, Facial defects, Local flap, Reliable

Abstract

The Limberg or rhomboid flap can be used to close defects almost anywhere on the body. It is versatile in that a random pattern flap can be raised from any one or all corners of the rhomboid. The defect is filled with tissue of the same thickness and colour, and with good vascularity. The purpose of this paper is to demonstrate the versatility that a single flap can be used to close defects almost anywhere on the body. This study was conducted in the department of plastic and reconstructive surgery, Saveetha Medical College and Hospital, during the period between January 2018 and December 2019. Twenty patients (fifteen males and five females) took part in this study. Their ages ranged from 20-60 years with a mean age of 42 years. From each patient history was taken and physical examination was performed. All the procedures were done under local anesthesia. Postoperatively suture removal was done on the 5th post-operative day. There were twenty patients who took part in the study. Seventeen patients had naevi and three had basal cell carcinoma. The size of the lesions ranged from 2.0×1.8 cm to 4.8×4.5 cm. All the flaps settled well with no complications. The procedure resulted in a very fine and less noticeable scar with smooth contour of the skin which was acceptable in all patients. Limberg flap is a safe and reliable option that could be used in the reconstruction of small and medium‐sized cutaneous defects of the face especially in elderly patients with no morbidity.

References

Aydin OE, Tan O, Algan S, Kuduban SD, Cinal H, Barin EZ. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med. 2011;43(1):1-8.

Chasmar LR. The versatile rhomboid (Limberg) flap. Can J Plast Surg. 2007;15(2):67-71.

Alvarez GS, Laitano FF, Siqueira EJ, Oliveira MP, Martins PDE. Use of the rhomboid flap for the repair of cutaneous defects. Rev Bras Cir Plást. 2012;27(1):102-7.

Khan AAG, Shah KM. Versatility of Limberg flap in head and neck. Int J Case Rep Images. 2012;3(6):13-8.

Corredor Osorio R. Rhomboid flap: An option to medial canthal reconstruction Our Dermatol Online. 2017;8(3):329-32.

Tamborini F, Cherubino M, Scamoni S, Frigo C, Valdatta L. A Modified Rhomboid Flap: The Diamond Flap. Dermatol Surg. 2012;38:1851-5.

Li Z, Jiang Y, Zhang JY. Modified O-T advancement flap for reconstruction of skin defects. Int J Clin Exp Pathol. 2017;10(9):9158-63.

Shah A, Zoumalan R, Constantinides M. Aesthetic Repair od Small to Medium-sized Nasal defect. Facial Plast Surg. 2008;24:1.

Gibson T. Modern Trends in Plastic Surgery. Butterworths, London, United Kingdom. 1964.

Turan T, Kuran I, Ozcan H. Geometric limit of multiple local Limberg flaps: A flap design. Plast Reconstr Surg Glob Open. 1999;104(6):1675-8.

Ng SG, Inkster CF, Leatherbarrow B. The rhomboid flap in medial canthal reconstruction. Br J Ophthalmol. 2001;85:556-9.

Rohrer TE, Bhatia A. Transposition flaps in cutaneous surgery. Dermatol Surg. 2005;31(8):1014-23.

Mathew J, Varghese S, Jagadeesh S. The Limberg flap for cutaneous defects- a two-year experience. Indian J Surg. 2007;29:184-6.

Pirozzi N, Pettorini L, Scrivano J. Limberg Skin Flap for Treatment of Necrosis and Bleeding at Haemodialysis Arteriovenous Angioaccess Puncture Sites. Eur J Endovasc Surg. 2013;46(3):383-7.

Becker FF. Rhomboid Flap in Facial Reconstruction. Arch Otolaryngol. 1979;105:569-73.

Sommerlad BC, Creasey JM. The stretched scar: A clinical and histological study. Br J Plastic Surg. 1978;31:34-45.

Dufourmentel C. An L-shaped flap for lozenge shaped defects: Principle - technique – applications. Transact Third Int Congr Plast Surg. 1964;772-3.

Quaba AA, Sommerlad BC. A square peg into a round hole: a modified rhomboid flap and its clinical application. Br J Plastic Surg. 1987;40:163-70.

Defektlerinin C, Rhomboid O, Cok F. Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med. 2011;43:1-8.

Dass T, Zaz M, Rather A. Elliptical Excision with Midline Primary Closure versus Rhomboid Excision with Limberg Flap Reconstruction in Sacrococcygeal Pilonidal Disease: A prospective, Randomized Study. Indian J Surg. 2012;74:4.

Borges AF. The rhombic flap. Plast Reconstr Surg. 1981;67(4):458-66.

Di Santis EP, Elias BL, Andraus EM. Rhomboid Flap: An Option to Many Anatomical Regions. J Adv Plastic Surg Res. 2015;1:14-8.

Townsend J. A template for the planning of rhombic skin flaps. Plastic Reconstruct Surg. 1993;92(5):968-71.

Aital SK, Rajan CS, Reddy N. Limberg flap for sacrococcygeal pilonidal sinus a safe and sound procedure. Indian J Plast Surg. 2003;75(4):298-301.

Rao Jk, Shende KS. Overview of Local Flaps of the Face for Reconstruction of Cutaneous Malignancies: Single Institutional Experience of Seventy Cases. J Cutaneous Aesth Surg. 2016;(4):220-5.

Divya GK, Shilpa K, Sarvajnamurthy S. Outcome of flap surgeries in dermatosurgical unit at a tertiary care center in india with a review of literature. J Cutan Aesthet Surg. 2016;9:226-31.

Lister GD, Gibson T. Closure of rhomboid skin defects: the flap of Limberg and Dufourmentel. Br J Plast Surg. 1972;25:300-14.

Ooshima M, Kochi M, Marioka D. Bipedicled Mini V-Y Advancement Flap for Skin Defect of the Face. Modern Plastic Surg. 2018;8:15-20.

Ng SGJ, Inkster CF, Leatherbarrow B. The rhomboid flap in medial canthal reconstruction. Br J Ophthalmol. 2001;85:556-9.

Downloads

Published

2023-04-20

Issue

Section

Case Series