OBJECTIVETo evaluate the design principles, clinical results and significance of hatchet skin flaps for repairing tissue defects in different parts of cheek.

METHODSThe area of cheek was divided into three parts, P(I), P(II) and P(III), with vertical lines through the medial canthus and lateral canthus. Different kinds of hatchet skin flaps were designed to repair tissue defects in different part of cheek. The hatchet skin flaps were performed in 29 cases with tissue defects in different part of cheek from August 2005 to August 2009. There were 17 male and 12 female, aged from 19 to 81 years, with a mean age of (45 ± 16) years. The size of tissue defect ranged from 1.5 cm × 1.5 cm to 2.5 cm × 3.5 cm. Patients' satisfactions were evaluated with a questionnaire in 5 aspects:color and texture match, scar, morbidity, and function after 6 months operatively.

RESULTSAll the flaps survived completely with good color and tissue match. The facial contour was not altered obviously. Six to eighteen months later, all scars were almost invisible. All 29 patients were satisfied with their results.

CONCLUSIONSThe hatchet skin flap is one of the versatile reconstructive methods for repairing of medium and small defects in the three parts of cheek. Defects in different part of cheek should be repaired individually with hatchet flap based on characters of natural lines.