New V-Y advancement method "Clione Method" for reconstructive surgery

The V-Y advancement flap is one of the most frequently used methods in plastic surgery. But the movement of the flap is sometimes disrupted by tension, and there are various practical methods to release the tension of the flaps. We investigated a new method modifying V-Y advancement, in which we add a slit-cut in the middle of the flap, and insert a triangle shaped skin surplus into the space which is usually trimmed. We named this method the "Clione Method", because it resembles a clione, a cold-ocean dwelling creature. We used this method in 7 cases (2 cases are presented in this article), which required large tissue reconstruction after radical resection of tumors or scars. In all cases, the "Clione Method" was useful for covering the defects with less tension at the tip of the flaps, and all the flaps successfully survived. The "Clione Method" has the following advantages: 1) It does not leave complicated scarring on the flap which directly covers the defect, 2) The skin surplus which is trimmed and discarded is reused naturally, 3) The sutured line does not become straight eventually, which can prevent scar contracture, and 4) The technique is simple. On the other hand, an additional cut must be made on the flap, and thus the method should be used only when the flap is not undermined beneath the flap, or when there is sufficient blood supply under the flap.