These chimeric flaps contain multiple tissue combinations, every with an impartial vascular supply. The sural artery flap is a Type A fasciocutaneous flap primarily based on the sural artery direct cutaneous branch of the popliteal artery. It is located between the popliteal fossa plus the midposterior lower-leg between the inside and a wide heads of the gastrocnemius lean muscle.
Wider flaps may be collected if the physician is ready to epidermis graft the donor space. The argument has a big caliber pedicle, however the anatomy within the perforator charter boat or vessels may be varying. Most ALTERNATIVE flaps, in our experience, require dissection of musculocutaneous perforator(s) and are sometimes equipped only by septocutaneous perforators.
Septocutaneous perforators of the peroneal artery provide its blood. It is utilized for protection of defects of the center and decrease third from the leg. The superficial peroneal nerve may be included with a phase of fibula. Use this flap designed for trunk, visage, abdomen, and thigh pains. The posterior interosseous artery flap is actually a Type Udemærket fasciocutaneous flap based mostly in the dorsal part of the fore arm between the radius and ulna.
) is definitely a fashionable argument for reduce limb reconstruction for a number of causes. It is predicated on an part of pores and skin and fascia on the anterolateral facet of the thigh provided by perforators of the descending department belonging to the lateral circumflex femoral artery.
Fibular Cost-free Flap
The pedicle size is 6-10 alt site cm, as well as its diameter is normally 2-3 mm. This flap can be utilized with respect to defects across the ankle, foot, and lower leg, and it is typically used to be a free flap. The detrás tibial artery flap is a Type B fasciocutaneous flap designed on the medial side of this leg from knee towards the medial malleolus. Based on septocutaneous perforators for the posterior tibial artery, it could be 6 times 18 cm.
This supplies a really significant flap (15 cm × 35 cm) with a long pedicle (up to 12 cm) giving a safeguards answer for the majority of defects within the decrease arm or leg. Other widely used fasciocutaneous free of charge flaps include the gigantic forearm (for smaller defects), the scapular flaps, and the parascapular flaps (raised round vessels close to the axilla). The latter are generally used throughout the ankle nevertheless could be difficult because of the size of the pores and skin. could be farmed as a cutaneous flap including pores and skin and subcutaneous structure based on the two a septocutaneous vessel or perhaps musculocutaneous perforator. It may be lifted as a amalgamated flap, consisting of a fascial (fasciocutaneous anterolateral upper leg flap) or perhaps muscular (vastus lateralis myocutaneous anterolateral thigh flap) aspect.
Fasciocutaneous Flaps Of The Lower Extremity
Perforator dissection could be tough and tedious to the unsophisticated microsurgeon. The dorsalis pedis flap can be described as Type T fasciocutaneous flap based on the dorsal pores and skin of the medial two thirds of the feet from the ankle to the toes and fingers. Its blood vessels provide is from the septocutaneous perforators from the dorsalis pedis artery and first hinten metatarsal artery.
The saphenous argument is a Type A fasciocutaneous flap based totally on the saphenous artery branch of the descending genicular subset of the shallow femoral artery. Design the flap in the distal inside thigh in order that it measures several x 20 cm; apply it for knee wounds. The posterior or perhaps gluteal leg flap relies on the pores and skin of the posterior thigh overlying the muscles femoris muscle tissue. Its bloodstream provide is the descending subset of the second-rate gluteal artery, identified midway between the trochanter and ischium. This flap regularly is used to cover ischial anxiety ulcers.
The pedicle is certainly three -4 cm in length and has a diameter of 0. 3-zero. eight logistik. This flap most frequently is employed for the purpose of protection of leg injuries across the shin. It can be utilised as a physical flap primarily based on the ” light ” peroneal nerve. Most of the flaps of the limb may be designed as superiorly based, distally established, island, or perhaps turnover flaps.
Posterior Arm rest Flap
It can also be designed within the lateral thigh between the bigger trochanter and knee with length and width of 7 back button 20 centimeter. Use the medial thigh argument, which is 15 x 20 cm and has a pedicle of two-4 cm using a 1 . a few mm diameter, for pains of the abdomen, groin, and perineum. Inside the proper affected individual, the epidermis and subcutaneous fat of your anterolateral thigh could be fairly thin, creating this flap a probably giant donor site of supple and typically sensate fasciocutaneous tissue. The skin paddle can be as giant simply because eight by 25 centimeters with major closure possible.
It may be raised with the detrás cutaneous neural of the leg for a sensate flap pertaining to buttock and perineal wounds. In the thigh, the lateral and medial leg flaps happen to be Type Udemærket fasciocutaneous flaps primarily based within the perforating branches of the profunda femoris and superficial femoral arteries, correspondingly. Use the horizontal thigh flap for cover of ischial and trochanteric defects.
The flap can measure 15 by 6 centimeter and may are the sural nerve as a neurosensory flap. The anterior tibial artery argument is a Type B fasciocutaneous flap situated on the anterolateral element of the limb between the leg and horizontal malleolus. Based upon the septocutaneous branches of the preliminar tibial artery, it could evaluate 6 x 18 centimeter.
The pedicle is certainly 2-four centimeter long and has a size of zero. 5-1 mm. It is employed for protection of defects of the center and lower third of the lower leg and might range from the saphenous neural for sensory innervation. The peroneal artery flap is known as a Type F fasciocutaneous argument based on the lateral lower body over the fibula extending through the top of the fibula to the spectrum of ankle malleolus.