These chimeric flaps contain multiple structure combinations, every with an unbiased vascular source. The sural artery flap is a Type A fasciocutaneous flap based mostly on the sural artery direct cutaneous branch of the popliteal artery. It is placed between the popliteal fossa and the midposterior leg between the medial and lateral heads for the gastrocnemius muscle mass.
Wider flaps may be farmed if the plastic surgeon is ready to skin area graft the donor space. The argument has a big caliber pedicle, even so the anatomy of the perforator ship or vessels may be varying. Most OLL flaps, in our experience, require dissection of musculocutaneous perforator(s) and are occasionally equipped exclusively by septocutaneous perforators.
Septocutaneous perforators of the peroneal artery furnish its blood. It is usually utilized for protection of defects belonging to the center and minimize third in the leg. The superficial peroneal nerve could also be included with a phase of fibula. Make use of this flap for trunk, visage, abdomen, and thigh wounds. The detras interosseous artery flap is known as a Type M fasciocutaneous argument based mostly in the dorsal element of the forearm between the radius and ulna.
) is a very fashionable flap for decrease limb renovation for a number of triggers. It is predicated on an part of pores and skin and fascia on the anterolateral facet of the thigh offered by perforators of the descending department with the lateral circumflex femoral artery.
Fibular No cost Flap
The pedicle size is 6-10 cm, as well as its diameter is normally 2-3 mm. This flap can be utilized with respect to defects over the ankle, ft ., and leg, and it is commonly used being a free flap. The posterior tibial artery flap is a Type B fasciocutaneous flap designed on the medial side for the leg in the knee to the medial malleolus. Based on septocutaneous perforators within the posterior tibial artery, it could be 6 by 18 cm.
This gives a really large flap (15 cm × 35 cm) with an extended pedicle (up to 12 cm) giving a cover answer for some defects belonging to the decrease arm or leg. Other commonly used fasciocutaneous absolutely free flaps include the gigantic forearm (for smaller defects), the scapular flaps, and the parascapular flaps (raised round boats close to the axilla). The latter are generally used throughout the ankle on the other hand could be troublesome because of the density of the dermis. could be collected as a cutaneous flap consisting of pores and skin and subcutaneous muscle based on both a septocutaneous vessel or musculocutaneous perforator. It may be enhanced as a amalgamated flap, consisting of a fascial (fasciocutaneous anterolateral leg flap) or muscular (vastus lateralis myocutaneous anterolateral leg flap) part.
Fasciocutaneous Flaps Of The Cheaper Extremity
Perforator dissection could be tough and tedious for the inexperienced microsurgeon. The dorsalis pedis flap may be a Type B fasciocutaneous flap based on the dorsal pores and skin of the medial alt com 2/3 of the ft . from the rearfoot to the foot. Its bloodstream provide is from the septocutaneous perforators for the dorsalis pedis artery and first dorsal metatarsal artery.
The saphenous flap is a Type A fasciocutaneous flap relying on the saphenous artery branch of the descending genicular subset of the shallow femoral artery. Design the flap over the distal inside thigh so that it measures six x twenty cm; make use of it for knees wounds. The posterior or gluteal thigh flap depends on the epidermis of the trasero thigh overlying the muscles femoris muscles. Its blood provide is a descending subset of the negative gluteal artery, identified half way between the trochanter and ischium. This flap regularly is employed to coat ischial stress ulcers.
The pedicle is three -4 cm in length and has a diameter of 0. 3-zero. eight logistik. This flap most frequently is used for protection of leg injuries across the shin. It can be put to use as a physical flap based mostly on the shallow peroneal nerve. Most of the flaps of the lower-leg may be designed as superiorly based, distally based upon, island, or turnover flaps.
Posterior Provide Flap
It can be designed over the lateral upper leg between the bigger trochanter and knee with proportions of 7 times 20 cm. Use the medial thigh argument, which is twelve x 20 cm and has a pedicle of two-4 cm with a 1 . five mm diameter, for pains of the abdominal, groin, and perineum. In the proper sufferer, the skin color and subcutaneous fat of the anterolateral leg could be pretty thin, making this flap a probably massive donor website of elastic and commonly sensate fasciocutaneous tissue. The epidermis paddle is often as giant since eight by simply 25 cms with most important closure possible.
It may be elevated with the detras cutaneous nerve of the thigh for a sensate flap pertaining to buttock and perineal pains. In the thigh, the lateral and medial leg flaps are Type T fasciocutaneous flaps primarily based relating to the perforating branches of the profunda femoris and superficial femoral arteries, respectively. Use the a wide thigh flap for safeguards of ischial and trochanteric disorders.
The flap can evaluate 15 x 6 centimeter and may are the sural neural as a neurosensory flap. The anterior tibial artery argument is a Type B fasciocutaneous flap located on the anterolateral area of the lower-leg between the knee and a wide malleolus. Depending on the septocutaneous branches of the susodicho tibial artery, it could measure 6 by 18 cm.
The pedicle can be 2-four centimeter long and has a diameter of absolutely nothing. 5-1 logistik. It is intended for protection of defects from the center and lower third of the calf and might are the saphenous neural for sensory innervation. The peroneal artery flap may be a Type N fasciocutaneous flap based on the lateral leg over the fibula extending from your top of the fibula to the extensive malleolus.