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Objectives: Oncological excision of tumors with minimal loss of cutaneous substance.
Achieve aesthetic repair

Introduction: The “Comma” flap is a modified “L” flap.

Materials / method: The "L" plasty is a classic flap that allows the removal of round-looking tumors that are part of a triangle of excision. The apex of the triangle in the area of skin with less laxity. The incision is extended one and a half times the length of the base. The flap is taken off and sutured with an angle point
The disadvantages of the “L” flap, especially when applied to the face, are twofold. It generates a much greater loss of cutaneous substance than the tumor because the circular area is transformed into a triangular one. It does not allow sutures to be inserted into natural folds.

Results: The Comma flap is a modified “L” plasty. It is a Rhomboid “L”. Tumor excision is circular with a safety margin. The loss of cutaneous substance is round. The surface slightly exceeds that of the tumor. To take the flap, an arcuate incision is made, preferably in a natural fold, the length of which can be up to twice the diameter of the loss of cutaneous substance. The flap is peeled off and sutured with an angle stitch. It is a surgery sparing in loss of cutaneous substance.

Conclusion: The “Comma” flap therefore has several advantages. In addition to being more economical in loss of cutaneous substance while remaining oncological, it is easy to perform. It allows to confuse the final sutures with the natural folds and a more aesthetic repair. It allows the excision of tumors in territories where integumentary laxity is limited to one side only (lips, eyelids, temple etc.) A few complications were observed: a spontaneously regressive bruise, transient paralysis of half the forehead, retraction which exceptionally required defatting and partial necrosis of the flap.

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请注明名称（个人，公司，学会等等）: Biofronteraa

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请注明名称（个人，公司，学会等等）: Biofrontera

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