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LOCAL FLAPS - Practical Plastic Surgery

LLOOCCAALL FFLLAAPPSSDD eeffiinniittiioonnssAflapis a piece of tissue with a blood supply that can be used to coveran open wound. A flap can be created from skin with its underlyingsubcutaneous tissue, fascia, or muscle, either individually or in somecombination. Depending on the reconstructive requirements, evenbone can be included in a flapimplies that the tissue is adjacent to the open wound inneed of coverage, whereas in a distant flap , the tissue is brought froman area away from the open wound. LOCAL flap coverageof a wound is the next higher rung up the recon-structive ladder after a skin graft. Examples of wounds that require flapcoverage include wounds with exposed bone, tendon, or other vitalstructure and large wounds over a flexion crease, for which a split-thickness skin graft or secondary closure would result in tight site:where the flap site:the open wound/soft tissue defect in need of :the blood supply of the flap ( , its arterial inflow andvenous outflow).

112 Practical Plastic Surgery for Nonsurgeons Skin Flaps Aportion of skin and subcutaneous tissue and, when possible, the under-lying fascia (the thin layer of connective tissue overlying muscle that has

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