Pacman flap method.

Abstract

The V-Y flap is a well-known method for closure of round skin defects. However, with conventional V-Y flaps, it is sometimes difficult to advance the flap sufficiently, especially where there is a lack of subcutaneous tissue. Thus, the authors have devised a new technique named after a famous Japanese video game. The flap design is almost the same as a conventional V-Y flap. Instead of cutting off the two triangular parts of the V flap, those two parts are rotated and advanced to meet at the center of the defect. The authors have operated on 18 patients with this method, and in all the cases, the flap survived completely. No secondary surgery was required to correct dog-ear deformity. This method is easy and can be applied in many situations. The authors conclude that this can be the first choice for closing circular skin defects.