Inverted edges, or the "Donut" technique
The mucosa around the hole is turned over and stitched to the other side. Small holes are closed completely, large ones partly: that is why it is almost always combined with a flap.
Written by the Septal Perforation team, patients, from the sources cited · Reviewed by doctors · Updated 2 November 2026 · Method and sources
In brief
Closes small holes completely, large ones partly.
Rarely used alone: it is combined with a flap.
Not possible if the edges of the hole are poorly healed or ulcerated.
The principle
The surgeon lifts the mucosa around the hole, turns it over like the rim of a sock, and stitches it on the opposite side. The opposite face is thus closed with local tissue.
Covering both faces of the hole is generally advised: a face left bare heals slowly, with dryness and crusts.
Source: Rusetsky, Mokoyan, ch. 10, in Alobid (ed.), Septal Perforation Repair, Springer 2026.
Who it is for, and who it is not for
Published results
The chapter mainly describes the technique; its figures come through the combined flap series.
Published series come from very experienced teams: they are ceilings, not promises. [[success-rates|The real success rates ›]]
Note before the consultation
Questions to ask the surgeon
- Are my edges well healed?
- Which flap do you combine it with?
- How many times a year do you perform this technique, and with what closure rate at 1 year? (All the questions: the guide.)
Frequently asked questions
Are inverted edges enough on their own?
For a small hole, sometimes. Otherwise they are combined with a flap that covers the operated face.
Sources
Every figure on this page comes from one of these publications. The year is the year of publication.
Read next
Keep reading