Design principles for transposition flaps: the rhombic (single-lobed), bilobed, and trilobed flaps.

BACKGROUND: When tension at a cutaneous defect is too great for primary closure or causes distortion of surrounding anatomy, transposition flaps provide a useful reconstruction option.

OBJECTIVE: To review the tissue biomechanics of the rhombic, bilobed, and trilobed transposition flaps.

MATERIALS AND METHODS: A systematic evaluation of a cutaneous defect is provided to guide a logical approach to the design and execution of transposition flaps.

RESULTS: Applying key principles to the design and execution of transposition flaps results in reliable outcomes.

CONCLUSION: Carefully designed and executed rhombic, bilobed, and trilobed transposition flaps provide an excellent reconstruction option when tension at a cutaneous defect is too great for primary closure.