Bishop Flap and Sigma Flap to Repair Surgical Defects in High-Tension Anatomical Regions

Abstract

Background: The reconstruction of surgical defects in high-tension anatomical regions is challenging due to the ischemia and subsequent necrosis associated with tension closure. Research on new flaps capable of closing these defects exerting less tension would be a tremendous advancement in dermatological surgery.

Patients and methods: We conducted a multicenter, retrospective study that used 2 new flaps-the bishop and the sigma ones-to repair surgical defects in high-tension regions such as the scalp, lower extremities, and the nasal pyramid. The bishop flap was used in 9 patients, 5 of whom exhibited their lesion in the nasal pyramid, 2 in the legs and another 2 in the scalp. The sigma flap was used in 6 patients, 5 of whom exhibited scalp lesions and 1 leg lesion.

Results: Uneventful and excellent results were obtained in all 15 patients due to infection, dehiscence, or necrosis.

Conclusions: Both the bishop and the sigma flaps are a good alternative to repair surgical defects in high-tension regions such as the scalp, lower extremities, or the nasal pyramid.

Keywords: Cirugía dermatológica; Colgajos cutáneos; Cuero cabelludo; Cutaneous flaps; Cáncer cutáneo; Dermatologic surgery; Leg; Piernas; Scalp; Skin cancer.