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Ancient Shield, Modern Flap: A Comparative Reflection on Peloponnesian Design and Triple Rhombic Flap in Reconstruction. | LitMetric

Ancient Shield, Modern Flap: A Comparative Reflection on Peloponnesian Design and Triple Rhombic Flap in Reconstruction.

J Craniofac Surg

Department of Neurosurgery, Armed Forces Capital Hospital, Bundang-gu, Seongnam-City, Gyeonggi-do, Republic of Korea.

Published: July 2025


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Article Abstract

The aim of this paper is to explore and compare the formal and functional parallels between the Peloponnesian shield and the triple rhombic flap, with implications for teaching and conceptual design in reconstructive surgery. The shield was photographed at the Archaeological Museum of Olympia and analyzed for its structural elements: central focal point, radial extensions, and directional flow. Also, clinical cases involving scalp reconstruction using triple rhombic flaps were reviewed. Core features such as angle, rotation, and spatial orientation were analyzed qualitatively. The Peloponnesian shield exhibits a triradial design, with each wing segment spaced at ~120 degrees from its neighbors, centered around the Gorgoneion medallion. Similarly, the triple rhombic flap is constructed by designing 3 rhomboid flaps spaced 120 degrees apart, which are rotated toward a central circular scalp defect. Both forms share principles of radial symmetry, distributed tension, and central protection. The shield not only served a physical defense role in battle but also carried significant symbolic meaning, embodying themes of identity, protection, and divine association. In contrast, the triple rhombic flap protects the cranial vault, restores function, and re-establishes the patient's physical and social identity. From the battlefield to the operating room, radial designs with a central core and three surrounding units have endured due to their structural harmony and protective function. The triple rhombic flap is, in many ways, a surgical shield-not of bronze, but of skin. Geometry remains the common language of both healing and history.

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http://dx.doi.org/10.1097/SCS.0000000000011707DOI Listing

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