In this paper, an optimized design for rhombic transposition flaps is created using a reliable finite element model that assures convergence for stress and deformation results. Defining a general configuration for rhombic flaps, the surgical process of wound closure is simulated for a wide variety of patterns. To address the intrinsic uncertainties associated with modelling skin's mechanical properties, four different sets of material parameters are considered, to investigate statistical measures. The results suggest that implementing the rhombic flap technique in a way similar to Z-plasty leads to an optimized surgical technique. The proposed flap, which can be employed for 60° to 90° rhombic defects, can reduce the maximum von Mises stress by 53% (on average) with respect to the Dufourmentel flap, and, in the case of a 60° defect, 43% with respect to the Limberg flap.
By Rajabi A, Dolovich AT, Johnston JD 