Basic Flap Design

Excerpt

Flap design and transfer for the closure of tissue defects that cannot be sutured primarily is a fundamental skill in the practice of reconstructive surgery. Because of the incredible breadth of tissue defects, one may encounter in a patient - small, skin-only defects up to large, multi-tissue-type defects - as well as the wide range of etiologies, such as traumatic, oncological, and congenital, the ability to transfer flaps requires a diverse set of competencies that must constantly evolve as new techniques are described, and new mechanisms of injury emerge. Understanding the anatomy and physiology of both the defect and potential donor sites is critical to successful flap transfer, as is mastery of atraumatic soft tissue surgical technique. Ultimately, flap design and transfer represent the clinical intersection of the science of medicine and the art of surgery, which renders these procedures either immensely rewarding or singularly frustrating, depending on the outcome.