Distant flaps

Direct distant flaps

Direct distant flaps are connected to the destination directly.

• Cross-finger flap – flap from 1 finger to adjacent finger with defect of the fingertip, secondary defect of the donor area is covered by skin flap;
• cross-leg flap;
• tubulated flap in the lower abdomen – wrist + hand defect coverage.

Indirect distant flaps

Indirect distant flaps are connected to the destination with the help of temporary host destination (usually on the wrist).

• Filatov flap – oblique strip of skin with subcutaneous tissue in the hypogastrium, length to width ratio 3:1 → tubulated flap → can be disconnected after 3-4 weeks at either end → after sewing + attaching to the wrist disconnect the remaining stem → transfer to the place of the defect;
• axial groin flap – used as both direct and indirect, nutrition from a. circumflexa ilium superficialis →ratio can be > 3:1.

Division according to the composition of the flap

Fasciocutaneous flaps

• Local flaps containing deep fascia on the lower limbs in a length to width ratio of 3:1;
• supplied by fascial vessels and perforators;
• safely cover e.g. bare bone or tendons;
• secondary defect is covered by skin flap.

Muscle and musculocutaneous flaps

Defined vascular supply, we rate:

• closeness to defect;
• necessity, resp. replaceability of the function (we try to keep a part of the muscle for its function);
• dominant vascular pedicle;

• defect in place of collection is usually covered by skin flap;
• most often we use thoracodorsal flap, gastrocnemius flap and flap of the rectus femoris muscle.

Links

Related articles

• Flaps
• Local flaps
• Free flaps
• Face reconstruction
• Nose reconstruction
• Face soft tissue injuries
• Upper lip reconstruction
• Lower lip reconstruction
• Skin transplants

Used literature

• MĚŠŤÁK, Jan. Úvod do plastické chirurgie. 1. edition. Univerzita Karlova v Praze - Nakladatelství Karolinum, 2005. 125 pp. ISBN 80-246-1150-3.