Workhorse Reconstruction: O-T Flaps

In this presentation, Kelsey Hirotsu discusses ODT flaps, also known as O-T, highlighting their advantages and disadvantages in reconstructive procedures, particularly focusing on facial and neck defects. Benefits of ODT flaps include their excellent vascular supply, versatile incision placement, and the ability to adapt the incision during surgery, making them user-friendly for trainees. Cons involve their need for significant undermining, particularly in patients on blood thinners, and limited tissue recruitment compared to other flaps. Hirotsu emphasizes the importance of orienting incisions with respect to skin laxity and tension vectors to minimize scarring. Throughout the talk, multiple case examples illustrate the successful application of ODT with favorable cosmetic results, particularly for forehead and neck defects. He also discusses the 'Mercedes repair' technique, which allows for better tension distribution and can complement ODT flaps in larger defects. Ultimately, Hirotsu concludes that ODT and Mercedes repairs serve as effective solutions for complex reconstructive challenges, emphasizing the value of combined techniques in achieving optimal aesthetic outcomes.