ArticleJPRAS open2026
The remote flap technique: recruiting regional laxity for reconstruction of high-tension cutaneous defects a descriptive single-surgeon case series.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Local flaps recruit laxity into a defect through incisions that extend from the defect into the immediately surrounding tissue; these incisions can disturb peri-defect perfusion and place scars within the aesthetic unit of the defect. The remote flap technique is a reconstructive strategy rather than a single flap entity. A zone of regional or distant laxity is identified away from the defect and recruited to achieve closure without an incision connecting the flap to the defect - the feature that distinguishes it from a conventional local flap - keeping the reconstructive work, and the resulting scar, away from the defect where this is advantageous. The flap raised at the remote site may itself be constructed as a local, pedicled, or free flap. Methods: A retrospective audit of 100 consecutive patients (112 remote flaps) treated at Kawana Private Hospital, Sunshine Coast, Australia, between 25 May 2022 and 1 January 2025 was performed, and flap-related complications were recorded. The operative principles, flap design, and a decision framework for the technique are described, with selected additional cases presented to illustrate specific considerations. Results: All 100 patients achieved successful reconstruction with 112 remote flaps. Lesions were squamous cell carcinoma (46.4%), basal cell carcinoma (26.8%), invasive melanoma (8.9%), melanoma in situ (8.0%), intraepidermal carcinoma (8.9%), and other (0.9%). Flap-related complications were infrequent: infection 3.6% (4/112) and dehiscence 0.9% (1/112), total 4.5% (95% CI 1.5-10.1%). Excision-related incomplete margins, independent of the flap, occurred in 1.8% (2/112). Conclusion: In this single-surgeon series the remote flap technique was a safe and reproducible option for high-tension cutaneous defects, with a flap-related complication profile consistent with published local-flap reconstruction. Potential advantages in local tissue preservation and scar placement are described but were not formally measured and require prospective comparative study.
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