Random Local Flap – Transposition
The skin adjacent to the defect is moved directly over the defect using combined rotation and advancement movements. The secondary defect is closed side to side.
The rhombic flap is a classical example of a transposition flap. The initial key closure is between DB’. In order to achieve this without tension, this movement must be in the lines and direction of the maximum tissue laxity. Therefore careful pre-operative evaluation of the laxity and relaxed skin tension lines is necessary before planning the design of the flap.
The classic rhombic transposition flap is itself a large flap and wastes a lot of normal skin around a circular defect in order to create the rhombus. A modification of the design results in a smaller flap to close a circular defect.