Reconstruction of Small to Moderate Size Peri-Auricular Skin Defects Using Hatchet Flaps

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Peri-auricular region is a special anatomical
area including the sideburn area anteriorly, hair superiorly,
the non-hairy post-auricular sulcus posteriorly, and the mandibular
angle and neck inferiorly. Reconstruction of defects
affecting this area should consider all these structures so that
hairy area has to be reconstructed with hairy flaps and the
non-hairy area has to be reconstructed with non-hairy flaps.
Local flaps in the form of hatchet type flap provide this
reconstruction aim. The Hatchet flap is a well-known flap < br />used to cover round defects with primary closure of the donor
sites in a V–Y fashion.
Methods: Hatchet flaps have been used in reconstruction
of defects in variable anatomical sites as published by the
senior author and proved to be a reliable flap providing stable
coverage of the defect by a skin flap from the adjacent area
and thus having similar color, texture, and sensation to the
lost skin.
Aim of Work: To describe how to utilize the hatchet flap < br />for reconstruction of small to moderate size peri-auricular
skin defects in order to provide satisfactory coverage, with
the best aesthetic outcome, inconspicuous scars in both the
donor and recipient areas, with the least possible complications.
Nine cases were presented in this study.
Results: Results were good, all defects were successfully
covered. The flaps survived completely, the likeness of hair
color and density in the sideburn area was achieved, and the
scars at the donor site were hidden in the post-auricular
hairline, post-auricular sulcus were maintained and not obliterated
by the flap in any of these cases. All patients were
shown a satisfactory appearance, with no complications both
on the recipient and donor sites.
Conclusion: Hatchet flaps are a versatile and reliable
technique for reconstruction of small to moderate size periauricular
skin defects which provides a stable coverage of the
defect, with safe vascularity of flaps, and provide an excellent
cosmetic outcome.

Keywords

Main Subjects

References

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