Bilateral interdigitated Pacman flap for round and oval facial defects

Abstract

Background: Skin texture and color are important considerations during the reconstruction of facial defects, and anatomical borders should be preserved. Therefore, a local flap is a better option. In these cases, the authors repaired facial defects using a bilateral interdigitated VY flap.

Objective: We aim to present a modified bilateral Pacman flap technique for the reconstruction of round and oval facial defects.

Materials and methods: We performed a retrospective chart review of 25 patients (26 cases) who underwent bilateral interdigitated Pacman flap repair of round and oval facial defects after Mohs surgery for skin cancer from January 2012 to December 2017. The defect sizes ranged from 0.7 to 8.4 cm² (mean 3.1 cm²).

Results: All defects were covered successfully and the flaps survived in all cases. One patient had partial flap necrosis that resolved spontaneously. No flap contraction, distortion, or severe scar formation was observed in any patient during the 12-month follow-up period.

Conclusion: The bilateral interdigitated Pacman flap can cover round and oval facial defects without distortion or central dog-ear deformity. This method is a useful option for facial restoration in selected cases.

Keywords: Flap; Head and neck neoplasms; Mohs surgery; Pacman flap; VY flap.