Versatility of hatchet flaps for the repair of scalp defects.

There are a number of approaches for the repair of scalp defects, including local, regional, and distant options. The use of a local double triangular hatchet flap has numerous advantages due to its mixed rotational and advancement components, its large size, and the possibility of maintaining the cosmetic appearance of the hairline as the flap has similar characteristics to those of the area to be reconstructed. We present our experience with a series of skin tumors of the scalp. After oncologic excision, immediate repair of the defect was performed using this double flap. The surgical technique and the advantages of this type of reconstruction are discussed. We believe that the hatchet flap is an ideal option for the reconstruction of moderate-sized scalp defects.