Expanding the scope of rhomboid flap: Large cutaneous defect reconstruction. Case report

and importance: Large cutaneous defects may result from excision of skin malignancies. Typically, skin grafting is used to manage such defects, but the final result may be compromised by inadequate take and poor cosmesis. Accordingly, transposition flaps may be indicated. Case Presentation and clinical discussion: A 93-year-old female presented with a painful, necrotic 12 cm × 12 cm Squamous Cell Cancer of left upper back. She underwent wide excision followed by a rhomboid transposition fasciocutaneous flap. The flap was easily designed, quickly executed, and did not require any special instruments. The overall result was a good cosmetic outcome with no complications. Our case outlines successful use of rhomboid flap instead of a more complicated option to reconstruct a very large cutaneous defect. The flap healed with excellent contour, texture, thickness, and color match. •A very large cutaneous defect was caused by excision of a Squamous Cell Cancer in an elderly female.•A rhomboid fasciocutaneous flap was easily designed, quickly executed, and inset without any special instruments.•The patient healed uneventfully with excellent contour, texture, thickness, and color match.•The excision design, flap elevation, rotation, inset, and post-operative photographs are included to educate readers.•The case has been presented based on SCARE guidelines.