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Flap classification
- 2.
- 3. Methods of classification •Composition – Skin +/- fascia – Muscle (+/- innervation) – Bone – Omentum / viscera – Composite • Proximity to defect • Method of movement • Vascular anatomy
- 4. Proximity to defect • Local • Regional • Distant • Free
- 5. Arterial supply ofthe skin
- 6. Method of movement • Advancement • Transposition • Rotation • Interpolation • Waltzing
- 7.
- 8. Type A Type B Type C Direct cutaneous Fasciocutaneous Musculocutaneous pedicle pedicle pedicle Deep external pudendal ALT ALT Digital artery Anterior + posterior tibial Deptopectoral Dorsal metacarpal Deltoid Nasolabial Gluteal Dorsalis pedis Median forehead Groin Inferior cubital (antecubital) Thoracoepigastric Lateral thoracic Lateral + medial arm (transverse abdominal) Pudendal Lateral + medial plantar Transverse back Saphenous Lateral + medial thigh Scalp Peroneal Forehead Posterior interosseous Superficial external Radial + recurrent pudendal Scapular Superficial inferior epigastric Ulnar Sural Temporoparietal fascia
- 10.
- 11. I One II Dominant III Two IV V Dominant vascular vascular dominant Segmental vascular pedicle pedicle + pedicles supply pedicle + minor secondary pedicle segmental pedicles Colon Gracilis Omentum EDL, EHL, Fibula Jejunum Hamstrings Gluteus FDL, FHL Lat dorsi maximus Tibialis ant DCIA Soleus Pec major Pec minor Sartorius Gastrocs SCM Rectus External TFL Trapezius Vastus Serratus oblique anterior lateralis Temporalis
Editor's Notes
- #5 Local Flap : When the skin flap is from an area close to the wound, for example, a wound on the lip may be repaired by a flap from the adjacent cheek. Regional Flap : When the skin flap is not from the adjacent area, but is from the same region of the body, for example, a wound on the tip of nose might be repaired with a flap from the forehead. Distant Flap: When a flap is from a different part of the body, for example, a wound on the hand might be repaired with a flap raised in the groin. A local flap repair is usually done in one operation, whereas regional and distant flaps need two or more operations. The second operation is needed to detach one end of the flap at the donor site, when the blood vessels have developed at the other end. Free Flap: This is a distant flap, but the whole procedure is done in one stage by repairing the donor and blood vessels by microsurgery.