Kapitel 78 – Local or subdermal plexus flaps Flashcards
How much does the perfusion decrease after initial elevation of a single pedicle and bipedical flaps?
10% and 40 % respectively
How long should an advancement flap be?
Minimum as long or preferably longer than the length of the wound to be closed.
List the types of subdermal plexus flaps
a. Advancement flaps
b. Rotation flap
c. Transposition flap
d. Interpolation flap
e. Plasty
f. Distant flap
g. Composite flap
What is the difference between a local flap and a distant flap?
a. Local flaps are developed adjacent to the recipient bed and can be used in most areas of the body.
b. Distant flaps are constructed at a distance from the recipient bed and are most commonly used for closure of wounds on extremities.
How is a single advancement flap created?
It is usually formed by two skin incisions that are equal in length to that of the defect. These incisions are started at each end of the wound bed, the margin of which constitutes the third side of the flap.
How is a bipedicle advancement flap created?
Bipedicle advancement flaps are created with an incision made parallel to the long axis of the wound. The width of the flap should approximate the width of the defect to be closed and the total length of the flap should be no more than twice the width of the flap base
What is an interpolation flap? Give an example of such flap
a. An interpolation flap is a rotating rectangular flap created distant to the defect. It has no common edge with the defect and therefore crosses intact skin.
b. Lip-to-lid flap
That are the three types of plasties used for regular skin reconstruction?
a. Z-plasty
b. V-Y-plasty
c. H-plasty
What are composite flaps and what are the most common used composite flaps in vet medicine?
a. Composite flaps incorporate underlying structures with the skin.
b. myocutaneous axial pattern flaps, such as the latissimus dorsi flap and mucocutaneous subdermal plexus flaps, based on the lips and labial mucosa.
What are the guidelines of the flap width in lip-to-lid flaps?
The sides of the flap should diverge so that the base is wider than the tip; if possible, the width across the base of the flap should be at least 50% of the length of the flap.
When are direct distant flaps most commonly used?
To cover a wound on a lower limb or foot, particularly if the wound is on the lateral surface
List the complications encountered after subdermal plexus flaps.
a. Infection
b. Seroma
c. Skin edge dehiscence
d. Necrosis
What are some systemic factors known to interfere with wound healing and therefore increases risk for flap dehiscence?
a. renal failure
b. hepatic failure
c. hyperadrenocorticism
d. hypothyroidism
e. administration of corticosteroids or chemotherapeutic agents
f. local radiation treatment.
What is the reported rate of dehiscence of flaps after radiation therapy?
64%
(35 % risk for necrosis and 27% of infection)
When is the risk of complications highest in regard of radiation therapy?
When radiation is performed before flap procedures because of damage to local fibroblasts and blood vessels.
