Skin Flaps

Question 1

Blood flow is maintained or immediately re-established when skin segment is moved to a new position with what?

Answer 1

Skin flap

Question 2

Blood supply is severed and new vessels must grow in from recipient site with what?

Answer 2

Skin graft

Question 3

What are 3 ways to classify skin grafts based on the types of blood supply used?

Answer 3

• Subdermal plexus
• Axial pattern flap
• Revascularized

Question 4

What are 2 ways to classify skin grafts based on the distance from the wound?

Answer 4

• Local

- Distant

Question 5

With local flaps the blood supply is usually based on what?

Answer 5

Subdermal plexus

Question 6

What are 2 types of skin flaps that do not rotate about a pivot point?

Answer 6

• Single pedicle advancement flap

- H-plasty

Question 7

2 Single pedicle advancement flaps placed together are known as what?

Answer 7

H-plasty

Question 8

What are 2 types of skin flaps that move about a pivot point?

Answer 8

• Rotation flaps

- Transposition flaps

Question 9

Where is a very common location for a single pedicle advancement flap?

Answer 9

Reconstruction of upper eyelid

Question 10

When donor skin is available on only one side, which type of flap is used?

Answer 10

Single pedicle advancement flap

Question 11

What type of blood supply is used with a single pedicle advancement flap?

Answer 11

Subdermal plexus flap

Question 12

What type of skin flap is used when simple undermining and advancement would result in excessive tension or distortion of surrounding tissue?

Answer 12

Single pedicle advancement flap

Question 13

Triangles of skin removed at the base of a flap to prevent dog ears from forming when the flap is advanced are known as what?

Answer 13

Burows triangles

Question 14

What type of an incision is made to start a rotation flap?

Answer 14

Arcing incision about 2 1/2 times the width of defect

Question 15

What is the second step of making a rotation flap?

Answer 15

Undermine deeply and advance the flap.

Question 16

If tension is present when making a rotation flap, what can be done?

Answer 16

Incrementally lengthen arcing incision until the tension is relieved.

Question 17

What can increase the mobility of the flap but also increases the risk of vascular compromise with a rotation flap?

Answer 17

Back cut incision

Question 18

What is a technique that can be used to prevent dog ears from forming?

Answer 18

Spread sutures further apart of the long side.

Question 19

What is usually done with small dog ears?

Answer 19

Nothing, usually resolve during healing.

Question 20

What should be done with large dog ears?

Answer 20

Should be removed.

Question 21

How many sides are on a transposition flap?

Answer 21

Three-sided flap

Question 22

The donor skin is in a different axis from the wound in what type of flap?

Answer 22

Transposition flap

Question 23

What effect does an increase in the angle from the wound have on the effective length?

Answer 23

The greater the angle from the wound, the shorter the effective length becomes.

Question 24

What is the most common angle range for a transposition flap?

Answer 24

60-90 degrees

Question 25

Transposition flaps that incorporate a direct cutaneous artery and vein are known as what?

Answer 25

Axial pattern flap

Question 26

The course of some direct cutaneous vessels is very predictable allowing large flaps incorporating those vessels to do what?

Answer 26

Be constructed without the length limitations of subdermal plexus based flaps.

Question 27

What are the 2 most common clinical applications for axial pattern flaps?

Answer 27

• Thoracodorsal

- Caudal superficial epigastric

Question 28

What is a technique that can be used where a portion of the flap between the donor and recipient sites is sutured into a tube to protect the vessels to maintain blood supply?

Answer 28

Tubing the flap