Purpose Our goal was to evaluate 2 design properties, pivot point and secondary defect, that affect the results of rotation flaps used to treat skin cancer defects of the head and neck. Materials and methods We conducted a retrospective review of the last 50 patients who underwent rotation flaps for closure of skin cancer defects on the head and neck with regard to postoperative complications. Results Four patients experienced complications, all of which were managed to an acceptable conclusion. These complications included tip necrosis and ectropion. Conclusion Rotation flaps, although simple in design, are often modified during their execution. Understanding the basic design and possible modifications of pivot point and secondary defect will yield a successful outcome.
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