Tagliacotian cross-arm flap reconstruction of facial defects.

The tagliacotian cross-arm flap finds its basis in one of the oldest reconstructive techniques known, the brachial flap of Gaspar Tagliacozzi. Although not commonly employed today, it remains useful in difficult orbital and nasal reconstructions. Our report deals with the historic development, applicability, timing, and technique of this procedure and is well illustrated by a case report. Advantages of the tagliacotian flap include no additional scarring in the exposed area and a hidden donor site. A considerable amount of usually non-hair-bearing tissue can be transferred without sacrifice of valuable muscle and without special surgical techniques. The tagliacotian cross-arm flap should be considered when local and regional tissue supply is inadequate, when aesthetic desires of the patient preclude additional local scarring, and when time allows for the training and transfer of this flap.