| Summary: | The choice between skin graft and local flap reconstruction depends upon the surgeon's experience and the facilities available. For skin cancers, our main objective is clear, oncologic clearance with preservation of function. For some patients, aesthetic outcome is often equally important. In our experience, majority of our trainees will often choose skin graft reconstruction as their primary choice of reconstruction due to the fact that there is a perceived idea that this is easier to perform than a local flap. However, for lower limb or head and neck reconstructions, skin graft may result in a significant contour defect which can potentially be avoided.We present a series of cases of an alternative flap, the trapezoid advancement, a very simple design that can be utilised in several areas of the body and technically very easily replicated. This technique allows for the advancement of tissue with a minimal tension closure as compared to other local flaps. Our results showed no flap loss and excellent cosmetic outcome.
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