The V-flap and the Berlin tulip flap: two new concepts in conventional flap techniques

Microsurgical operations are costly and technologically demanding. We have therefore developed new conventional flap techniques using state-of-the-art knowledge of skin anatomy and circulation. The V-flap is a combination of the V-Y advancement flap and two Limberg flaps 2]. Sixty patients treated by the new flap technique have shown a low rate of complication. Even when used in difficult regions of the body or in very large defects, the V flap has proven to be very effective. It has been adopted as a standard flap technique in our hospital. The Berlin tulip flap is another very reliable flap. To form the tulip flap, the outer corners of a subcutaneous pedicle flap are curved backwards. When detached, they can be transposed to the healthy tissue on the contralateral side. This completely relieves the midzone, which then can be safely closed in the same manner as a V-Y flap. The Berlin tulip flap is particularly useful for covering trunk defects and managing sacral ulcers in paraplegics.Correspondence to: E. Vaubel