Skin Flaps and Grafts Flashcards
1
Q
Skin Flap (aka pedicle graft or pedicle flap)
A
- Portion of skin and subcutaneous tissue with a vascular__ attachment moved from one area of the body to another
- Blood flow is maintained or immediately re-established when skin segment is moved to new position
2
Q
Skin Graft
A
- A segment of skin that is completely removed from the body and transferred to a recipient site
- Blood supply is severed and new vessels must grow in from recipient site
3
Q
Indications for skin flaps
A
- Defects with poor vascularity
- Areas difficult to immobilize
- Defects overlying cavities (ex orbit)
- Areas where padding and durability essential
4
Q
Skin graft indications
A
- Major loss of skin (trauma, tumor removal)
- Distal extremities
- Full-thickness burns
5
Q
Skin Flap Classification
A
- Location
- Distant from the defect
- Adjacent to defect
- Blood supply
- Subdermal plexus flaps
- Axial pattern flaps
- Tissue types
- Just skin and subcutaneous tissue
- +/- muscle, cartilage, and bone
6
Q
Axial pattern flaps
A
- Blood supply from direct cutaneous artery and vein
- Excellent blood supply!!!
7
Q
Subdermal plexus flaps
A
- Blood supply from subdermal plexus - from terminal branches of direct cutaneous artery
- Includes all other types of flaps
8
Q
Local flaps - flaps that rotate around a pivot point
A
- Rotation flaps
- Transposition flaps
9
Q
Local flaps - flaps that do not rotate around a pivot point
A
- Single pedicle advancement flaps
- Bipedicle advancement flaps
- H-plasty flaps
- V-Y advancement flaps
10
Q
Rotational flaps
A
- Local flaps are pivoted over a defect.
- Flap and defect share a common border!
- Create incision in stepwise fahsion until no tension
11
Q
Transposition flaps
A
- Rectangular flap created within 90 degree of the long axis of the defect
- Width of flap = width of defect
- Note the effect of rotation on flap length - will decrease flap length
12
Q
Interpolation Flaps
A
- Rotating rectangular flap that lacks a common border with the skin defect
- Flap covers skin between donor and recipient
- Second surgery to excise redundant skin
- *you leave the pedicle intact - otherwise it would be considered a skin graft
13
Q
Single-Pedicle Advancement Flaps
A
- One of the most commonly used in vet med
- Formed in loose, elastic skin and slid over the dfeect
- Flap incisions made parallel to lines of least tension!
14
Q
H-plasty (bi-pedicle advancement flaps)
A
- two advancement flaps coming from either direction to meet eachother in the middle
- Cut triagnles out again to prevent dog ear effect
- As it comes together, sutured at an H
15
Q
Pouch, hinged, and tube pedicle flaps
A
- Location - distant flaps (skin still stays on pedicle!)
- Blood supply - subdermal plexus
- Multi-stage procedures
- Used more for lower extremity skin defects
16
Q
Pouch Flaps
A
- Create two incisions - undermine - then give a dog or cat a pocket to stick the paw in
- Secondary surgery - excise area of pouch that had been left in tact
- Excise dorsal and ventral margin
- Then close the original wound
17
Q
Tubed Pedicle Flaps
A
- Two parallel incisions - sutured to eachother around tube
- Closing up the wound underneath the tube
- Tube needs to heal entirely (10-14 days)
- Tube of skin hanging off the patient - excise upper/proximal portion of the tube and walk tube down to area of interest
19
Q
One of the most commonly used axial pattern flaps is:
A
Caudal superficial epigastric axial pattern flap
20
Q
Caudal superificial epigastric axial pattern flap
A
- Ventral midline is medial incision
- Lateral incision is parallel to the first, at a distance equal to the distance from the mammary teats to the midline
- I.e - teats will be the midpoint of the flap
- Cranial extent is between 1st and 2nd glands
27
Q
Mesh Grafts
A
- Pros
- Allows expansion of graft to cover larger defects
- Allows drainage of blood and serum from under graft
- Allow graft to conform better to uneven structures
- Application
- Suture or staples on all free edges and midline
28
Q
A
Punch grafts
