The Use of Rotation Flap to Cover a Facial Defect—A Case Study

Background: There are often situations that require the correction of facial defects. Local fasciocutaneous flaps provide a reasonable option for reconstruction of facial defects with good colour and texture match and good success rate. Among the various options of local flaps is the use of a rotation flap. Aim: The aim of this work is to demonstrate the reliability of the rotation flap in the correction of facial defects and its ability to achieve a good aesthetic outcome by applying the knowledge of facial aesthetic units. Case Presentation: This is a case report of a 28-year-old woman who suffered an avulsion injury to the face with loss of facial tissue resulting in exposure of the left zygomatic bone. The defect measured 5 cm × 6 cm. A rotation flap was used to cover the defect after the wound had been previously irrigated and debrided. Her wounds healed well. She suffered no facial nerve injury. The rotation flap resulted in a good colour match with no disruption of facial contour. Conclusion: The Rotation flap provides a reasonable option for reconstruction of facial defects with good colour and texture match.


Introduction
The reconstructive surgeon is often confronted with situations that require the correction of facial defects. There is a wide range of options available to the reconstructive surgeon for repairing a given facial defect. These include traditional methods like healing by secondary intention and primary closure. Other options include the use of a skin graft, the use of local or regional flaps, as well as free tissue transfer [1] [2] [3] [4] [5].
Local fasciocutaneous flaps provide a reasonable option for reconstruction of Thus, they often produce superior functional and aesthetic results. Among the various options of local flaps is the use of a rotation flap. A rotation flap is a semicircular skin flap that is rotated into the defect on a fulcrum point. Rotation flaps provide the ability to mobilize large areas of tissue with a wide vascular base for reconstruction [7].
Rotation flaps are particularly useful when the proposed donor site of the flap is the lateral aspect of the face. These flaps are advantageous because they have a particularly wide base and thus have an excellent blood supply. Their disadvantage is that they may require relatively extensive cutting beyond the defect to develop the flap, thus increasing the risk of nerve damage as well as bleeding [8] [9].
One of the important considerations in any type of facial surgery, especially in facial reconstructive surgery, is the use of the aesthetic subunits. Gonzales-Ulloa The aim of this work is to demonstrate the reliability of the rotation flap in the correction of facial defects and its ability to achieve a good aesthetic outcome by applying the knowledge of facial aesthetic units.

Case Report
This is a case report of

Discussion
A facial injury can be one of the most challenging problems presented to the reconstructive surgeon. Trauma can lead to complex facial injuries with missing tissue. Motor vehicle collisions make up the majority of these injuries followed by bite wounds and ballistic injuries [11].
Patients with facial injury may have their lives and self-esteem compromised temporarily or permanently [12]. The ultimate objective of treatment is to achieve functional and cosmetic restoration. Local flaps in the armamentarium of the reconstructive surgeon when aptly applied well serves this purpose.
A local flap comprises the skin and subcutaneous tissue with a direct vascular supply, which is transferred to an adjacent or nearby site. Local flaps have several advantages such as reliable blood supply, good skin texture, and colour match.
Additionally, most provide a single-stage procedure An argument against primary use of local flaps is that this flap is eliminated as to bear in mind [14].
1) Incisions and closures should be along relaxed skin tension lines (RSTLs).
2) Closures should be tension free. This is best accomplished by undermining the skin along the lines of maximal extensibility (LME). LME is the direction in which skin is most extensible and runs perpendicular to RSTLs.
3) Flaps should respect and preserve facial aesthetic and functional subunits.

Conclusion
The Rotation flap provides a reasonable option for reconstruction of facial defects with good colour and texture match. With proper planning and execution, rotation flaps are a versatile technique that can be used to produce excellent functional and cosmetic outcomes in the reconstruction of facial defects.

Patient Consent
The patient provided written consent for the use of her images.

Conflicts of Interest
The author declares no conflicts of interest regarding the publication of this paper.