List of plastic surgery flaps

Plastic surgery flaps are critical components in reconstructive surgery, allowing surgeons to repair defects in the skin and underlying tissues by moving "flaps" of tissue from one part of the body to another. This article provides an overview of the various types of flaps used in plastic surgery, emphasizing their importance, applications, and the principles underlying their use.

Types of Flaps

Plastic surgery flaps can be broadly categorized based on their blood supply, composition, and method of transfer. The main types include:

Local Flaps

Local flaps are segments of tissue that are moved to cover an adjacent defect while maintaining their original blood supply. They are often used for facial reconstruction due to their proximity to the defect site and the match of skin texture and color.

• Advancement Flap: Moves directly forward without rotation or lateral movement.
• Rotation Flap: Rotates around a pivot point to cover a defect.
• Transposition Flap: Transferred across an intervening space to reach the defect.
• Interpolation Flap: Passed over or under a bridge of skin to the recipient site.

Regional Flaps

Regional flaps are larger than local flaps and are used to cover defects that cannot be closed with local tissue. They may require dissection of the blood supply to be moved to the recipient site.

• Pedicled Flap: Remains attached to the original site by a stalk that contains the blood supply.
• Island Flap: A type of pedicled flap where the skin and subcutaneous tissue are detached, leaving only the blood supply connected.

Free Flaps

Free flaps are completely detached from their original location and transplanted to the defect site. The blood vessels are reattached to vessels near the defect using microvascular surgery.

• Muscle Flaps: Composed primarily of muscle; used when bulk is needed or in areas with poor circulation.
• Fasciocutaneous Flaps: Include skin, subcutaneous tissue, and fascia; used for surface defects.
• Perforator Flaps: Based on specific perforating vessels, allowing for preservation of muscle and reduced donor site morbidity.

Composite Flaps

Composite flaps contain multiple types of tissue, such as skin, muscle, and bone, and are used for complex reconstructions, such as in the face and jaw.

Principles of Flap Surgery

The success of flap surgery depends on several key principles:

• Blood Supply: Adequate blood supply is crucial for the survival of the flap.
• Tissue Match: The flap should match the recipient site in terms of tissue type, color, and texture.
• Minimizing Donor Site Morbidity: The removal of the flap should not significantly impact the function or appearance of the donor site.

Applications

Plastic surgery flaps are used in a wide range of reconstructive procedures, including:

• Breast reconstruction after mastectomy
• Facial reconstruction following trauma or cancer surgery
• Repair of congenital defects
• Reconstruction after burn injury

Conclusion

Plastic surgery flaps are a cornerstone of reconstructive surgery, offering versatile solutions for repairing defects across the body. Advances in surgical techniques continue to expand the possibilities for restoration of form and function following injury or disease.

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