Skin Flaps Flashcards
When do you use flaps and grafts?
Used to close skin defects especially in situations where the wound will not heal completely or well by second intention
-close wounds without tension
Flaps
Maintain connection to the donor site at one end (at least)
-depend upon blood supply coming from donor area to survive. Maintaining this limits the length and position of flap
Grafts
Used for tissue removed entirely from donor site and placed in recipient site
-can be vascularized (microsurgery), or not (common in vet med)
*common in horses
Flap types
- Subdermal plexus flaps
- Axial pattern flaps
-regular transposition flaps
-island flaps
Subdermal plexus flaps (random pattern flaps)
Nourished by subdermal plexus
-must keep cutaneous trunci with the skin
-should not be more than twice as long as it is wide
-base needs to be wider than tip
Subdermal plexus flap: Rotation flaps
-based on general stretch of skin
-arc meeds to be at least 3x length
-undermine the flap
Subdermal plexus flaps: single pedicle advancement flap
-should be perpendicular to lines of tension
Transposition flap
Keeps base, but instead of advancing, you turn it
-can be axial position flaps and subdermal plexus flaps
Skin fold flaps
Lots of extra tissue in inguinal or axillary regions
-can be transposed to adjacent thoracic or abdominal wall, or limbs
Flank fold options:
Axillary fold flaps
Axial pattern flaps
-contains a cutaneous artery
-usually transposition flaps
*up to180degrees
-transposed by bridging incisions or tubing middle part
-robust closure for high motion/high pressure areas
-usually small animals, sometimes horses
Transillumination technique
-raise flap, use surgery light to determine silouhette of artery
Island flaps
When are axial pattern flaps used?
Used for large wounds of head, neck, proximal extremities
-follow angiostomes
-skin/hair remembers where it came from
Lateral genicular axial pattern flap
Caudal superficial epigastric axial pattern flap
-external pudendal artery exits inguinal ring, branches into CGE . Extends cranially along mammary chain
-includes glands 3,4,5 and can choose to include gland 2
-good closure of medial thigh wounds
Superficial branchial axial pattern flap
Thoracodorsal axial pattern flap
