Basic Flaps

Excision of skin lesions can result in defects of various sizes and shapes, which can encompass various layers and tissues. The reconstruction should aim to replace the resultant defect in terms of size, shape, contour, colour and, if possible, function. This will require reliable tissue to be harvested from a site, which fulfils the above characteristics and places the secondary defect in the most advantageous position. In the head and neck region, a flap is often harvested from a site close to or distant from the defect for the “best” match. This requires sourcing flaps from areas with adequate tissue laxity and placement of scars along RSTLs, without causing distortion of the adjacent structures and landmarks. The basis and technique of harvesting local flaps in the head and neck region are described in detail in this chapter.