European Journal of Plastic Surgery

, Volume 42, Issue 2, pp 211–212 | Cite as

The pivot point in transposition flap planning: concept and surgical implications

  • Klaas W. MarckEmail author
  • Jan J. van Wingerden
Short Communication

It was recently demonstrated that rotation flaps are curvilinear advancement flaps and do not rotate [1]. Transposition flaps, however, are flaps that do rotate on the surface plane of the body. The verb “transpose” means to change something from one position to another, or to exchange the positions of two things. In a surgical context, it means that the position of tissue is changed by an operative procedure (nerve transposition, vessel transposition, skin transposition). The term “transposition” was used as early as 1855 by Denucé, as a general term for local skin transfer (“transfer” being the currently preferred term) [2]. The term “transposition flap,” to describe a skin flap that rotates around a pivot point in the base of the skin pedicle to close an adjacent skin defect, became popular in the 1970s.

In geometrical terms a pivot point is the center point of any rotational system [ 3]. In surgical terms, it is the center of the arc around which a flap moves during its transfer [ 4]...


Compliance with ethical standards


No funding has been received for this study.

Conflict of interest

Klaas W. Marck and Jan J. van Wingerden declare that they have no conflict of interest.

Ethical approval

For this type of article, formal consent from a local ethics committee is not required.

Informed consent

For this type of article, informed consent is not relevant.


  1. 1.
    Marck KW, van Wingerden JJ (2018) A rotation flap does not rotate. Eur J Plast Surg 41(4):483–484CrossRefGoogle Scholar
  2. 2.
    Marck KW, Martin D (2016) Jean-Louis-Paul Denucé (1824-1889): un pionnier oublié de la chirurgie plastique. Ann Chir Plast Esthet 61(1):55–59CrossRefGoogle Scholar
  3. 3.
  4. 4.
    Giele H, Cassell O (2008) Plastic and reconstructive surgery (Oxford specialist handbooks in surgery). Oxford University Press, Oxford, p 756Google Scholar
  5. 5.
    McGregor IA (1972) Fundamental techniques of plastic surgery, 5th edn. Churchill Livingstone, Edinburgh, p 123Google Scholar
  6. 6.
    Dufourmentel C (1962) La fermeture des pertes de substance cutanée limitée: le lambeau de rotation en L pour losange dit “LLL” 1962. Ann Chir Plast 7(1):60–66Google Scholar
  7. 7.
    Roggendorf E (1980) The oblong parallelogram-shaped “Schwenklappen”-plasty. Plast Reconstr Surg 65(5):635–655CrossRefGoogle Scholar
  8. 8.
    Gunther JP, Sheffield RW (2009) Transposition cheek skin flaps: rhombic flap and variations. In: Strauch B (ed) Grabb’s encyclopedia of flaps, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, p 272Google Scholar
  9. 9.
    McGregor IA, McGregor FM (1986) Cancer of the face and mouth: pathology and management for surgeons. Churchill Livingstone, Edinburgh, pp 25–123Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Plastic SurgeryLeeuwarden Medical CenterLeeuwardenNetherlands
  2. 2.Department of Plastic, Reconstructive & Hand Surgery, Academic Medical CenterUniversity of AmsterdamAmsterdamNetherlands

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