Useful Flaps for Plastic Surgeons to Know | Journal CME Article-Journal CME Article: Useful Flaps for Plastic Surgeons to Know Article

Journal CME Article: Useful Flaps for Plastic Surgeons to Know Article

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The article from the Plastic and Reconstructive Surgery Journal by Peter C. Neligan outlines various surgical flaps utilized in reconstruction, emphasizing their practicality in clinical settings. The author focuses on flaps from head to toe, highlighting their features and specific applications, and sharing personal insights that enhance their use.<br /><br />Neligan discusses pedicle dissection techniques, particularly for propeller flaps, which rely on rotation around perforator vessels. He provides general guidelines for flap size, emphasizing the importance of visual confirmation of perforators via exploratory incisions, given the unreliability of Doppler imaging alone. The text stresses the necessity of adequate dissection to prevent complications like strangulation of the blood supply.<br /><br />Several specific flaps are detailed, including:<br />- <strong>Facial Artery Perforator Flap</strong>: Useful for perioral defects and offering more reach when used as a propeller flap.<br />- <strong>Submental Flap</strong>: Versatile for areas such as the lower face, often enhancing neck contour.<br />- <strong>Internal Mammary Artery Perforator Flap</strong>: Reconstructs chest and neck defects with considerations for pedicle length.<br />- <strong>Intercostal Artery Perforator Flaps</strong>: Utilized for chest wall and breast reconstruction.<br />- <strong>Scapular Flaps</strong>: Based on the circumflex scapular artery, ideal for neck and shoulder regions.<br />- <strong>Thoracodorsal and Dorsal Scapular Artery Perforator Flaps</strong>: Skin-focused applications, conserving muscle and aiding defects in upper body regions.<br />- <strong>Superior Gluteal Artery Perforator Flap</strong>: Suitable for buttock and lumbar areas, preserving gluteal functionality.<br />- <strong>Anterolateral Thigh and Posterior Tibial Artery Perforator Flaps</strong>: Known for their robustness in lower extremity reconstruction.<br />- <strong>Medial Plantar Flap</strong>: Provides durable glabrous skin for heel defects.<br />- <strong>Keystone Flap</strong>: Emphasized for its simplicity and effectiveness without needing perforator dissection.<br /><br />Neligan concludes by asserting the practicality of these flaps in reconstructive surgery, acknowledging personal success and encouraging their consideration for various defects.

Keywords

surgical flaps

reconstruction

pedicle dissection

propeller flaps

perforator vessels

facial artery perforator flap

submental flap

internal mammary artery perforator flap

scapular flaps

keystone flap