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The Gundersen flap is a reconstructive surgical technique primarily used in the field of otolaryngology, particularly for repairing defects in the nasal region and the surrounding structures after oncologic resections, trauma, or congenital malformations. This flap is characterized by its unique design, which utilizes skin and subcutaneous tissue that is based on the dorsal nasal or forehead area, allowing for a robust vascular supply to the flap, thereby enhancing its survival and integration into the surrounding tissues. Typically, the flap is raised as a rotational flap, meaning that it is rotated around a pivot point to cover the area of defect, most commonly in cases involving nasal alar reconstruction and complex facial contour restoration. The versatility of the Gundersen flap lies in its ability to provide adequate coverage for varying sizes of defects while also matching the skin texture and pigmentation of the surrounding areas, which is essential for aesthetic outcomes. The surgical procedure involves careful planning and measurement to ensure that the dimensions of the flap adequately cover the defect without compromising blood supply. A vital aspect of the Gundersen flap technique is the preservation of the underlying vascular structures, particularly the superficial temporal artery and accompanying veins, which are crucial for maintaining perfusion to the flap post-operatively. The harvesting of the flap typically involves undermining the surrounding tissue to facilitate mobility while avoiding damage to the neurovascular bundles. Once the flap is mobilized and positioned over the defect, meticulous suturing techniques are employed to secure the flap in place, and sometimes, skin grafts may be necessary to optimize coverage. The postoperative care involves monitoring for perfusion, managing any potential complications such as infection or flap necrosis, and ensuring proper healing to achieve the best functional and aesthetic outcomes. The Gundersen flap has garnered significant popularity due to its reliability and effectiveness, presenting a favorable option for surgeons when addressing challenging reconstructive scenarios. In addition to nasal repairs, the Gundersen flap can also be adapted for use in other areas of the face and scalp, showcasing its versatility in reconstructive procedures. While complications are possible, with appropriate technique and patient selection, the Gundersen flap serves as an excellent option for achieving satisfactory wound closure and restoring both form and function. Overall, this flap technique remains an important tool in a surgeon's repertoire, making it a valuable option in the complex field of facial reconstruction.