RESUMEN
<p><b>OBJECTIVE</b>To investigate the application of forward and reversal flow axial island flap in the orbital skin defects.</p><p><b>METHODS</b>According to the distribution of superficial temporal artery as well as the anastomoses with the branches of supraorbital artery and supratrochlear artery, etc, the frontal, scalp, preauricular and postauricular island flaps were designed. The flaps were displaced through subcutaneous tunnel to cover all kinds of orbital skin defects.</p><p><b>RESULTS</b>13 cases of forward flow flap and 9 of reversal flow flap out of 22 cases in all were observed. One postauricular reversal flow axial island flap showed the obstruction of venous refluence in early postoperative stage, however, after active treatment, mere the distal epidermal necrosis was revealed. There were six re-operations on the postoperative flap hypertrophy. The others were in good shape and functional state.</p><p><b>CONCLUSIONS</b>The superficial temporal artery is one of most vital blood supply in the upper face. It has wide anastomoses with the supraorbital artery and supratrochlear artery. As the colors and the nature of the frontal, preauricular and post auricular skin are close to orbital skin, the application of forward and reversal flow axial island flap based on the superficial temporal artery can be used in the reconstruction of all kinds of orbital skin defects.</p>