DS11 Bridge to success: scope and utility of the bipedicled bridge flap

Abstract

Medium-sized defects of the scalp, temple, forehead and lower leg can be challenging to reconstruct in an aesthetic fashion. The author proposes the use of a hybrid flap that is at times bipedicled, perforator and/or axially supplied. This report describes the author’s experience with the bridge flap and its various subtypes. An institutional review board-approved prospective single-centre study was carried out of all bridge flaps performed at all Skin Centre facilities during 2015–2025. The design and method of dissection are detailed and illustrated, with photos and short video clips, including each hybrid of the bridge flap. The bridge flap is a single-stage local flap that provides appropriate tissue match by harnessing adjacent laxity of tissues to recreate the original anatomy of the surgical site without disturbance of free margins or aesthetic landmarks. There were 71 flaps in male patients and 32 in female patients. The median defect size was 11.6 cm2. There were two cases of infection and one episode of minor necrosis. The bridge flap is simple to perform and a reliable and robust method of obtaining immediate tissue reconstruction for ­medium-sized defects of the scalp, temple and forehead