The double hatchet flap is a versatile reconstructive surgical technique primarily used to close moderate-to-large scalp defects following the removal of tumors like basal cell carcinoma or squamous cell carcinoma.
Key Characteristics of the Double Hatchet Flap Mechanism: It combines rotation and advancement movements, where two triangular flaps on opposite sides of the defect are moved toward each other.

Indications: Most effective for defects typically ranging from 2 to 5 cm in diameter.
Design Ratios: For optimal closure, the flap length is typically 1.5 to 2 times the diameter of the defect, with a vascular pedicle width at least one-third to one-half the defect’s diameter to ensure adequate blood supply.