The helix flap for circular skin defects: case reports
Received: 17 March 2008 / Accepted: 14 October 2008 / Published online: 5 November 2008
Abstract After tumor resection, skin defects generally
form circular shapes. However, closure of circular skin
defect cannot be achieved satisfactorily by direct suture.
Local flaps or skin grafts can be used to cover such defects.
However, performing a graft or flap can require additional
tissue resection to convert the flap’s shape to the defect’s
shape. Reconstruction of these defects may cause problems
such as distortion of anatomic points and extra normal skin
resection. To solve those problems, a new local flap is
reported; this is a combination of transposition, rotation,
and subcutaneous flap techniques. This flap has been
performed with success on various body surfaces for
defects of a size ranging from 1.5 to 9 cm in diameter. In
this paper, technical details and some clinical cases are
Keywords Circular skin defect
Following the excision of skin neoplasms, a circle is one of
the most common surgical defects. Closure options for the
circular defects are numerous [1–3], and the best choice for
any given patient depends on many factors including the
size and location of the defect and mobility of local tissue.
There is, however, no general consensus on satisfactory
results when tissue excision or alteration in shape of the
circle is required [4–7].
A new flap to cover circular defects has been designed.
The “helix” flap is composed of a variation of rotation,
advancement, and subcutaneous pattern flaps. The advan-
tages of this flap are: no extra skin excision and no
alteration of the circular defect shape. The flap can also be
easily used in large defects. It is especially useful in the
torso, abdomen, flank, sacral, and gluteal areas in which
there is a thick layer of subcutaneous tissue [8–10].
Materials and methods
A circular defect is formed following tumor excision or
debridement. Following this, a nearly semicircle arch is
designed over the defect with a width of at least the radius
of the defect. The width of arch can be gradually increased
as much as the diameter of the defect at the base of the flap.
After the skin incision, the flap is undermined; this is
carried out at the distal portion of flap. It should not exceed
a half of the flap length. To reduce the donor site defect
size, a pursestring suture can be used, but it should not pass
the flap base. The prepared flap is rotated and advanced
upon itself to create a helix or spiral. The spiral-shaped flap
Eur J Plast Surg (2009) 32:195–198
Department of Plastic and Reconstructive Surgery,
Vakif Gureba Research Hospital,
Division of Plastic and Reconstructive Surgery,
University of Miami,
Miami, FL, USA
T. Turkaslan (*)
Fahrettin Kerim Gokay cd.Dağdelen apt. 240/39 81040,