How to use a gel template for an exact facial flap transfer.

A variety of materials have been used as template materials to aid in the design of local facial flaps. The biggest criticism of these materials is that they do not conform sufficiently to complex defects. This report describes the use of a hydrogel sheet wound dressing (ClearSite, NDM, Akron, Ohio) as a template material. ClearSite appears to make an ideal template material because it is thin, pliable, transparent, and inexpensive. This gel template adequately conforms to irregular three-dimensional shapes. It has the added beneficial ability to "lift" marking pen lines, which can then be transferred as an exact replica of the defect size. A case is presented in which a ClearSite template directed the transfer of the exact amount of forehead tissue following excision of a complex congenital nevus of the nose. Use of the ClearSite template seems well suited to help in local facial flaps and is likely to simplify the design of many distant flaps as well.