Abstract
Reconstruction of the scalp after suspected skin lesions excision is a challenge. Tamir et al. described the three-point-advancement (Mercedes flap) to close circular wounds. These tissue advancements create triangles in the edges, which must be removed. However, extensive lesions do not allow the three points to join, preventing central closure. Valesky et al. described the central closure using total skin grafts made from the triangles. The literature lacks these case reports, making it difficult to incorporate them into surgical practice. We applied this modified technique to five patients with good aesthetic and functional results.