Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 20;10(9):e4183.
doi: 10.1097/GOX.0000000000004183. eCollection 2022 Sep.

Dufourmentel Flap for Scalp Reconstruction

Enrique J Viciana  1 , Anne-Sophie Lessard  2
Affiliations

Dufourmentel Flap for Scalp Reconstruction

Enrique J Viciana et al. Plast Reconstr Surg Glob Open. .

Abstract

Transposition flaps are useful for reconstruction of many skin defects. Limberg described a rhomboid rotation flap in 1946. Dufourmentel described an improved version of the Limberg flap in 1962. The Dufourmentel flap is also a quadrangular rhomboid flap which can be used in any area of the body except for the central face, the fingers, and the volar hand. The design of the Dufourmentel flap creates a wider base for this random flap, thus making it more reliable. Where tissue loss is significant, or where skin and soft tissue elasticity is limited, double opposing Dufourmentel flaps are useful. A variation of the Dufourmentel flap is described where a circular defect is converted to a square. The line of greatest extensibility is marked through the circular defect or lesion. A square is marked around the circle with one corner of the square tilted 10-20 degrees counterclockwise from the line of greatest extensibility. After marking corners A, B, C, and D, lines are marked extending BD and CD. The first incision, DE, will bisect the angle created by extending BD and CD. The second incision, EF, is roughly perpendicular to CD extended, but the angle at E is opened up a bit to create a wider base for the flap. Point D will rotate to point B, E rotates to C, and F translates to D. The invisible line DF should be approximately parallel to the line of greatest extensibility. When the defect is relatively large or where the surrounding tissues have limited elasticity, the above-described ideal variation of the Dufourmentel flap may not be possible because the flap may not rotate and advance all the way around without tension. In this case, double opposing Dufourmentel type flaps have been found to be useful by meeting each other at the halfway point.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
A 78-year-old man presented with this defect of the scalp vertex following Mohs excision of a squamous cell carcinoma.
Fig. 2.
Fig. 2.
Double opposing Dufourmentel-style flaps were designed for closure of the defect.
Fig. 3.
Fig. 3.
This is the appearance of the area on postoperative day 12.
Fig. 4.
Fig. 4.
Depiction of the original design of the Dufourmentel flap.
Fig. 5.
Fig. 5.
Depiction of the author’s modification of the Dufourmentel flap, where a circular defect is converted to a square.
See this image and copyright information in PMC

Similar articles

  • Rhombic Flaps.
    Macneal P, Hohman MH, Adlard RE. Macneal P, et al. 2024 Apr 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. 2024 Apr 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 32644357 Free Books & Documents.
  • Triple Dufourmentel hexagonal flap for scalp reconstruction.
    Moreno-Casas G, Pereira-González A, Rodríguez-Nevado I, Narváez-Moreno B, Chaves-Álvarez A, Peral-Rubio F. Moreno-Casas G, et al. Exp Dermatol. 2023 May;32(5):694-698. doi: 10.1111/exd.14764. Epub 2023 Feb 26. Exp Dermatol. 2023. PMID: 36779680
  • Modified Dufourmentel flap, easy to design and tailor to the defect.
    Imafuku K, Hata H, Yamaguchi Y, Inamura Y, Kitamura S, Yanagi T, Shimizu H. Imafuku K, et al. J Dermatol. 2017 Jan;44(1):68-70. doi: 10.1111/1346-8138.13568. Epub 2016 Sep 7. J Dermatol. 2017. PMID: 27600299
  • Rhomboid Flap.
    Hon HH, Chandra SR. Hon HH, et al. Atlas Oral Maxillofac Surg Clin North Am. 2020 Mar;28(1):17-22. doi: 10.1016/j.cxom.2019.11.005. Epub 2020 Jan 2. Atlas Oral Maxillofac Surg Clin North Am. 2020. PMID: 32008705 Review. No abstract available.
  • Rhomboid flap: Indications, applications, techniques and results. A comprehensive review.
    Kang AS, Kang KS. Kang AS, et al. Ann Med Surg (Lond). 2021 Jul 7;68:102544. doi: 10.1016/j.amsu.2021.102544. eCollection 2021 Aug. Ann Med Surg (Lond). 2021. PMID: 34285803 Free PMC article. Review.
See all similar articles

References

    1. Kubo K, Takei H, Hamahata A. Rhomboid flap reconstruction after mastectomy for locally advanced breast cancer. J Nippon Med Sch. 2021;88:63–70. - PubMed
    1. Newlove T, Trufant JW, Cook J. The bilateral Dufourmentel flap for repair of nasal dorsum defects after Mohs micrographic surgery. Dermatol Surg. 2016;42:320–326. - PubMed
    1. Aydin OE, Tan O, Algan S, et al. . Versatile use of rhomboid flaps for closure of skin defects. Eurasian J Med. 2011;43:1–8. - PMC - PubMed
    1. Andrade P, Brinca A, Vieira R, et al. . Double rhomboidal flap for reconstruction of large surgical defect of the labial commissure. An Bras Dermatol. 2012;87:456–458. - PubMed
    1. Borgognone A. Double opposing triangular flaps for circular skin defects: Clinical considerations. Plast Reconstr Surg Glob Open. 2018;6:e2033. - PMC - PubMed