# A new local flap technique for closing long-axis skin defects: the cyclist flap procedure

## TL;DR

A new surgical technique called the cyclist flap procedure was developed to effectively close long-axis skin defects with good aesthetic results and minimal complications.

## Contribution

The cyclist flap procedure offers a novel solution for closing long-axis elliptical skin defects, which previously lacked suitable treatment options.

## Key findings

- The cyclist flap procedure was successfully applied in 29 patients with long-axis skin defects.
- The procedure resulted in acceptable aesthetic outcomes and no need for secondary surgeries.
- Only minor complications were observed in two patients during the follow-up period.

## Abstract

Local flaps are commonly used during the treatment of skin tissue defects. Although there are many available procedures for the closure of triangular, circular and rhomboid-shaped defects, long-axis elliptical skin defects lack treatment options. To address this problem, a new local flap design called the cyclist flap procedure (CFP) was developed, so called because it resembles the silhouette of a person riding a bicycle.

The CFP was performed in 29 patients aged 9–81 years in 2021–2022. The defects were localised in the sacral region (1), upper extremities (3), lower extremities (3), and head and neck regions (22). Closures of skin defects due to pressure ulcers (one patient) and after tumour excision (28 patients) were performed, and the patients were followed up for 12–20 months.

Only minor complications were observed in two patients. During follow-ups, no secondary surgery was required due to dog-ear, trapdoor, recurrence or revision. Furthermore, the aesthetic results related to the skin lines and scar size were acceptable.

The CFP is a new, easy-to-apply and advantageous procedure for the closure of long-axis elliptical and oval skin tissue defects.