Local Soft Tissue Rearrangement: The Random V–Y Flap, Rhomboid Flap, Random Rotational Flap, and Z-Plasty

Local soft tissue rearrangement involves a wide array of local flaps that can be utilized to close soft defects in the extremities. While local random flaps are relatively easy to perform, their utility is limited in traumatic or chronic wounds. The traumatic zone of injury and chronic soft tissue changes limits the effectiveness of small random soft tissue flaps. The random V–Y flap, rhomboid flap, and rotational flaps that are discussed in this chapter are good options for reconstructing small acute iatrogenic wounds. Lengthening of a scar and scar contractures is often addressed by the use of Z-plasties; however, occasionally, an adjacent soft tissue transfer is appropriate.