Island rotation flap for nasal reconstruction

Nasal reconstruction options are often dictated by size and location of the defect. Local flaps are often considered of little utility for larger or more complex defects. The authors' modification of the island rotation flap allows increased versatility and single-stage reconstruction for many more defects of varied sizes and locations. A retrospective review of all cases of nasal reconstruction using the island rotation flap over a 3.5-year period was undertaken. Ninety-two island flap reconstructions were performed for defects ranging from 0.8 to 4.0 cm. For defects smaller than 2.5 cm, there were no cases of flap loss. Five percent of the patients required a second procedure, whereas 95 percent were reconstructed in a single stage. Five percent required treatment for prominent scars. Follow-up was over 2 years. The laterally based blood supply of the nasal island rotation flap is reliable and robust. Patients treated with this flap had good healing and good symmetry and required minimal revision. Single-stage reconstruction with this flap requires both proper flap design and extensive undermining of the entire nasal soft-tissue cover. Nasal symmetry is maintained despite the defect and donor flap being on the same side of the nose. The authors present their technique for the island rotation flap for nasal reconstruction and information on its reliability and acceptance.