The Mercedes flap and its new variants: a ‘workhorse’ flap for the dermatological surgeon?

Abstract

The Mercedes flap and its modifications prove to be a good alternative to other closure types, especially in problem regions such as the shoulder, malleolar region, heel, etc. The procedure is fast and simple, with few side-effects, and proves to be a 'workhorse' flap for the dermatological surgeon.

Triple Advancement Flap for the Lateral Upper Forehead and Temple

“…Variations of the Mercedes flap have been described. 2,4 We frequently use the Mercedes flaps for repair of circular or oval defects on the forehead, temple, and preauricular cheek areas. We have found it to be particularly useful for the lateral upper forehead and the temple next to the lateral canthus.…”

“…We have found it to be particularly useful for the lateral upper forehead and the temple next to the lateral canthus. 2 Our technique is as follows. Following the clearance of tumor after Mohs, the reconstruction is planned and marked.…”

“…It has been previously described for closing primary excisional defects on difficult-to-close anatomic locations such as the shoulder, temple, sternum, heel, malleolar region, and the scalp. 2 First characterized by Tamir et al, 3 it has been described as a combination of a purse-string suture, dogear repair, and multidirectional advancement flap for the closure of circular wounds. It is particularly useful in areas of bi- or trifurcation of contour and tension lines.…”

“…Forehead, eyebrow, and hairline distortion must be avoided by carefully selecting tension vectors. Additional tissue is taken to form a triangular defect shape, 2 and the defect is undermined. Then, a central 3-point anchoring absorbable suture is placed in the center of the defect.…”

“…We have found it to be particularly useful for the lateral upper forehead and the temple next to the lateral canthus. 2…”