ISSN 2398-2942      

Skin flap: pedicle

icanis
Contributor(s):

Laura Owen

Daniel Smeak

Synonym(s): plastic surgery; reconstructive surgery


Introduction

  • Wound reconstruction, eg carcinoma external nose Skin flap 08 carcinoma of external nose , following wide local excision Skin flap 04 skin deficit after wide local excision , hemangiopericytoma Skin flap 04 hemangiopericytoma over perineal region , deficit following compartmental resection Skin flap 12 deficit following compartmental resection or reconstruction of a traumatic wound, utilizing skin flap(s) retaining its original vascular supply.

Uses

Conventional flaps - random subdermal flaps

  • Vascularized solely by capillaries in subdermal plexus until neovascularization establishes a secondary blood supply from the recipient bed Skin flap 01 vascular arrangement of the random skin flap :
    • Advancement flaps Skin flap 02 advancement flap.
    • Rotation flaps Skin flap 10 reconstruction.
    • Transposition flaps Skin flap 11 transpositional flap Reconstruction of wound with transpositional flap.

Axial flaps

  • Vascularized by single direct cutaneous vessel Location of major direct cutaneous artery supply.
  • Common axial flaps include:
    • Caudal superficial epigastric for lower abdomen, groin and medial thigh.
    • Deep circumflex iliacs for lateral thigh and lumbar region.
    • Omocervical for cranial shoulder and cervical region.
    • Thoracodorsal for thoracic, forelimb and axillary region.
    • Caudal auricular for head.

Advantages

Axial flaps

  • Longer and more mobile than conventional flaps.
  • Mobility increased by:
    Either Complete detachment of skin: direct cutaneous vasculature left attached to donor site.
    Or Microvascular techniques used to re-anastomose to fresh vascular supply in local area of defect.
  • Intentional incorporation of an axial vessel in a flap improves blood supply to the distal region, improving results, reducing risk of wound infection.
  • Allows for long, narrow pedicles to transfer donor skin to remote areas.

Disadvantages

Conventional flaps

  • Viability determined largely by pedicle base width and vascularity Skin flap 01 vascular arrangement of the random skin flap.
  • Smaller and less mobile than axial flaps.

Axial flaps

  • Careful pre-operative planning and patient positioning to include axial vessel in reconstruction.
  • Technically more challenging.
  • Some techniques complex, eg microvascular anastomosis for orthotopic graft transfer.
  • Surgeon must ensure that axial vessel has not been damaged.

Requirements

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Preparation

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Procedure

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Aftercare

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prognosis

  • Good depending on site and extent of area to be repaired.

Further Reading

Publications

Refereed papers

Other sources of information

Related Images

Want more related items, why not
contact us

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code