Versatility of the O-Z Flap in the Reconstruction of Facial Defects.

Background: The O-Z flap has traditionally been used for surgical defects adjacent to critical anatomic structures requiring a repair option that minimizes distortion and functional impairment. However, another advantage of the O-Z flap is that it is tissue conservative, particularly in comparison to primary closure. In fact, the design simply takes the Burow's triangles that would be discarded and rotates them inward.

Objective: The purpose of this work is to detail the type of post-Mohs defects, which might benefit from consideration of the O-Z flap with emphasis on tissue conservation and restoration of contour to the surgical site. Furthermore, the authors wish to describe unique considerations in each location and methods to appropriately plan the O-Z flap in each circumstance.

Methods And Materials: The authors reviewed all flaps classified as O-Z in their tumor registry. The approximate size of the defect reconstructed, complications, and long-term outcomes were recorded.

Results: O-Z flap implementation is described in detail for repair of defects located at the lateral nasal tip, nose-cheek junction, medial canthus, and mid-cheek.

Conclusion: The O-Z flap can be effectively used to repair defects located at the lateral nasal tip, nose-cheek junction, medial canthus, and mid-cheek. It is a mechanically simple flap with predictable tension vectors, which can be specifically oriented to protect the free margin.