ROM(Reducing Opposed Multilobed) Flap Repair for the Treatment of Medium Sized Skin Lesion.

Cho, Jong Je; Hong, Yoon Gi; Seo, Sang Won; Chang, Choong Hyun

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(6):748-752.
Published online November 1, 2006.

ROM(Reducing Opposed Multilobed) Flap Repair for the Treatment of Medium Sized Skin Lesion.

Jong Je Cho, Yoon Gi Hong, Sang Won Seo, Choong Hyun Chang

Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. hipson21@dreamwiz.com

Abstract

PURPOSE
Circular skin lesions between 10 and 35 mm in diameter generate problems often. Direct closure of the lesion risks excessive wound tension or wound dehiscence. Skin grafts heal slowly and often remain unsightly. Traditional skin flaps have a limited role. We treated this circular medium-sized skin lesion(10 - 35 mm sized) by reducing opposed multilobed(ROM) flap. METHODS: ROM flap involves a series of semicircular lobes extending both cephalic and caudal from the defect. Direction of the semicircular multilobed flap is set parallel to relaxed skin tension line(RSTL) to minimize scar formation. First semicircle is drawn 60% in diameter of the defect. Second semicircles are drawn at the cephalic and caudal aspects of the original semicircles. These semicircles are 60% in diameter of the first semicircle. Additional semicircles are repeatedly drawn until the tension of skin flaps becomes free. ROM flap has a length-to-base ratio of 0.5 resulting in lower theoretical risk of end flap necrosis than a random pattern flap with a large ratio. The technique involves lobes most distant from the primary defect being transposed in turn closer to the defect.
RESULTS
The ROM flap reduces skin tension concerns, lowers the risk of flap necrosis and allows for quicker and more aesthetic healing.

Results
were generally good and major complications, such as dehiscence, infection, or delayed healing, did not occur.
CONCLUSION
ROM flap repair allows the plastic surgeon an additional option when faced with a circular medium-sized skin lesion.

Keywords: ROM flap; Medium-sized skin lesion; RSTL