• Vol. 36 No. 10, S27–S30
  • 15 October 2007

The Role of Advancement Flaps in Peri-ocular Reconstructive Surgery



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Introduction: The advancement flap is a method of mobilisation of tissue in a linear direction so as to achieve closure of a primary defect. This technique has been used extensively in the field of ophthalmic reconstruction and has undergone modifications to suit the needs of the surgery. Methods: The PubMed database was used to search for articles using the keywords “periocular” and “advancement flaps” and we included the relevant cross references for other articles, books and chapters on the different types of advancement flaps used for peri-ocular reconstructive surgery. We present a summary of our findings in this review. Results: We present a range of different types of advancement flaps which include the single advancement flaps, double advancement flaps and Burow’s triangle flaps. We also discuss the use of segmental artery based flap, the island pedicle advancement flap, V-Y advancement flaps and sliding tarsal flaps to repair tissue defects of the peri-orbital region. The benefits and limitations of each of these techniques are highlighted. Conclusion: The advancement flap and its modifications are practical and simple techniques that add to the armamentarium of reconstructive procedures for the ophthalmic surgeon in the management of peri-ocular defects.

The advancement flap is a modality of skin defect closure via mobilisation of tissue along a linear direction. It is one of the most versatile flaps used commonly in many surgical disciplines including ophthalmology. This technique may be used to close a variety of defects of various sizes and shapes around the eyelids, eyebrows, glabella, forehead, temple, medial and lateral cathal regions. The peri-orbital region is an area where advancement flaps, either random (with cutaneous or musculo-cutaneous vasculature) or a pedicled (with a segmental artery), will survive well because of the rich blood supply in the head and neck.

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