AnatomyOrganismsDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesHumanitiesHealth Care
Surgical FlapsButtocksPectoralis MusclesRectus AbdominisMyocutaneous FlapReconstructive Surgical ProceduresMammaplastyFree Tissue FlapsDisarticulationThoracoplastySalivary Gland FistulaHyoid BoneHemipelvectomyPerineumEar Deformities, AcquiredSkin TransplantationHead and Neck NeoplasmsMastectomySoft Tissue NeoplasmsSurgical Wound DehiscenceHip ContractureDebridementPostoperative ComplicationsTreatment OutcomeAbdominal WallLaryngectomyCompartment SyndromesSternumEstheticsNeoplasm Recurrence, LocalMuscle, SkeletalFlap EndonucleasesKnee-Chest PositionThighSacrococcygeal RegionContractureSurgical MeshPiriformis Muscle SyndromePerforator FlapSubcutaneous FatBreast NeoplasmsTorsoAbscessTuberculosis, CutaneousFasciaLumbosacral PlexusHidradenitis SuppurativaArteriesSweat Gland DiseasesPhialophoraRhabdomyolysisInjections, IntramuscularPressure UlcerIliumCarcinoma, Squamous CellBone NeoplasmsRetrospective StudiesIliac ArteryPesticide ResiduesIliac AneurysmSciatic NerveAbdomen
Rectus Abdominis MyocutaneousPerforator flapsReconstructionTRAMInferiorFibular flapLatissimusAnterolateral thighTissueBreastSurgeryGluteus maximusComplexityProceduresComplicationsSurgeryMusculocutaneousInferior epigasAnterolateral ThighAutologousThighProcedureNecrosisSurgicalMedialFreeDIEAPResectionPerforatorsDonor site scarMorbidityMuscleSkinDefectsAnatomyIncludeImplantsApproachSite
Rectus Abdominis Myocutaneous2
  • Technique The Transverse Rectus Abdominis Myocutaneous free-flap, created from the transverse abdominal muscle, is a breast reconstruction flap harvested from the abdomen of the woman. (wikipedia.org)
  • The use of the muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric (DIEP) artery and vein flaps in breast reconstruction allows for excellent shape and contour of the breast mound while minimizing donor site morbidities related to abdominal strength and contour. (medscape.com)
Perforator flaps8
  • Understand the history and controversies surrounding perforator flaps. (elsevierpure.com)
  • 2. Describe the anatomy and understand the theories surrounding the physiology of perforator flaps. (elsevierpure.com)
  • 3. Understand the uses of perforator flaps in reconstruction. (elsevierpure.com)
  • SUMMARY: Perforator flaps have the advantages of reduced donor-site morbidity, versatility to accurately replace the components required at the recipient site, a longer pedicle than is achievable with the parent musculocutaneous flap, and freedom from orientation of the pedicle. (elsevierpure.com)
  • Many articles now attest to the safety and reliability of perforator flaps. (elsevierpure.com)
  • This review aims to outline the history and controversies surrounding perforator flaps and to describe the anatomy of the "workhorse" perforator flaps and their use in microsurgical reconstruction. (elsevierpure.com)
  • These flaps include the deep inferior epigastric artery, the anterolateral thigh, the thoracodorsal artery, and the superior and inferior gluteal artery perforator flaps. (elsevierpure.com)
  • Perforator Flaps -- 8. (nshealth.ca)
Reconstruction11
  • Free-flap breast reconstruction is a type of autologous-tissue breast reconstruction applied after mastectomy for breast cancer, without the emplacement of a breast implant prosthesis. (wikipedia.org)
  • As a type of plastic surgery, the free-flap procedure for breast reconstruction employs tissues, harvested from another part of the woman's body, to create a vascularised flap, which is equipped with its own blood vessels. (wikipedia.org)
  • Breast-reconstruction mammoplasty can sometimes be realised with the application of a pedicled flap of tissue that has been harvested from the latissimus dorsi muscle, which is the broadest muscle of the back, to which the pedicle ("foot") of the tissue flap remains attached until it successfully grafts to the recipient site, the mastectomy wound. (wikipedia.org)
  • The clinical advantage of the free-flap breast reconstruction procedure is avoidance of the medical complications-infection, malposition of the breast implant(s), capsular contracture-which occasionally occur consequent to breast-reconstruction surgery procedures that emplace breast prostheses to the mastectomy wounds. (wikipedia.org)
  • The clinical disadvantages of free-flap breast reconstruction surgery are: (i) the technical complexity of the plastic surgery procedure, (ii) prolonged surgical operation times, (iii) additional, secondary scarring at the flap-tissue donor site, (iv) possible medical complications at the flap-tissue donor-site, and (v) possible necrosis of the tissues harvested to create the free-flap. (wikipedia.org)
  • Therapeutically, the free-flap breast reconstruction procedure is always possible after radiation oncology for the treatment of breast cancer. (wikipedia.org)
  • The division of the superior epigastric blood supply, by a previous surgery, precludes a pedicled TRAM flap as the feasible method for breast reconstruction. (wikipedia.org)
  • 158. "Total breast reconstruction with the fat-augmented latissimus dorsi (FALD) flap: High safety in a single-center uncontrolled case series. (diepflap.it)
  • 151. "A multicentre study of the relationship between abdominal flap and mastectomy weights in immediate unilateral free flap breast reconstruction and the effect of adjuvant radiotherapy. (diepflap.it)
  • A study by Di Pace et al indicated that in immediate unilateral abdominal free flap breast reconstruction, better outcomes are obtained if the flap weighs approximately as much as or more than the mastectomy tissue. (medscape.com)
  • If you smoke or are overweight, talk with your plastic surgeon about problems that may occur after surgery with implant or flap procedures , such as delayed wound healing, infection and reconstruction failure. (komen.org)
TRAM3
  • The TRAM flap is composed of skin, adipocyte fat, and the musculus rectus abdominis, which is perfused (irrigated) by the deep inferior epigastric artery and by the deep inferior epigastric vein. (wikipedia.org)
  • Once the TRAM free flap is transposed to the woman's chest, the epigastric blood vessels are anastomosed (connected) to the internal thoracic vein to maintain the tissue viability of the reconstructed breast. (wikipedia.org)
  • Create a TRAM (Transverse Rectus Abdominus Myocutaneous) flap by taking muscle, fat, and skin from your abdomen to build a new breast. (soodcenter.com)
Inferior3
  • Move tissue from the buttocks or abdomen by creating a DIEP (Deep Inferior Epigastric Perforator) or SGAP (Superior Gluteal Artery Perforator) flap. (soodcenter.com)
  • The first gives branches to the adductor brevis and magnus, biceps femoris and gluteus maximus and anastomoses with the inferior gluteal, medial and lateral femoral circumflex. (passmed.uk)
  • Deep Inferior Epigastric Artery Perforator Flap. (nshealth.ca)
Fibular flap2
  • Refinements in mandibular reconstructions have led to the use of the free fibular flap, which results in improved appearance and function of the neomandible (see the image below). (medscape.com)
  • Fibular Flap -- 7. (nshealth.ca)
Latissimus1
Anterolateral thigh2
Tissue4
  • because it possesses a robust blood supply, there is a low risk of tissue necrosis, either of the flap or of the adipocyte fat, and the reconstructed breast can tolerate oncologic radiotherapy. (wikipedia.org)
  • Volume displacement oBCS or reshaping procedures that transpose a dermoglandular flap of breast tissue into the defect site (e.g., mastopexy and mammoplasty) (Figure 2) . (snec.com.sg)
  • At its most basic level, a flap is a portion of tissue that can be dissected, elevated, and inset into a nonanatomic position as a consequence of its vascular supply and outflow. (medscape.com)
  • It includes techniques with local flaps, such as the plug flap and mammoplasty techniques, neighborhood flaps, such as the thoracodorsal flap, alloplastic materials (tissue expanders and prostheses), the numerous autologous flaps, including microsurgical flaps or, also, the combined techniques for the various types of cases. (rbcp.org.br)
Breast1
  • In surgical praxis, the abdomen is the primary donor-site for harvesting the tissues to create the free flap, because that region of the woman's body usually contain's sufficient (redundant) adipocyte fat and skin -tissues that are biologically compatible and aesthetically adequate for the construction of a substitute breast. (wikipedia.org)
Surgery1
  • In reconstructive surgery it is often used for the creation of myocutaneous flaps. (lookformedical.com)
Gluteus maximus1
  • The secondary donor-sites for harvesting adipocyte and skin tissues to create a free flap are the regions of: (i) the gluteus maximus muscles, (ii) the medial thigh, (iii) the buttocks, and (iv) the waist of the woman's body. (wikipedia.org)
Complexity1
  • Complexity may range from a random pattern skin flap based on a subdermal plexus to a fascio-osteocutaneous free flap supplied by a known arterial perforator. (medscape.com)
Procedures1
  • For more information on various flap procedures, see Flaps . (medscape.com)
Complications3
  • 7. Outcome and Complications following Vertical Rectus Abdominis Myocutaneous Flap Surgery to Reconstruct Sacrectomy Defects. (nih.gov)
  • Postoperative complications such as vascular thrombosis, hematoma, and flap congestion were noted. (docksci.com)
  • A literature review by Chieng et al indicated that the use of flaps in patients who develop wound complications following spinal surgery increases the chance of hardware salvage in these patients. (medscape.com)
Surgery1
  • The 'pedicled' Latissimus Dorsi musculocutaneous flap (LD flap) and the 'pedicled' ThoracoDorsal Artery Perforator Flap (TDAP flap) have been described in the section on breast conserving surgery. (beautifulabc.com)
Musculocutaneous2
  • 2] then defined the concept of perforating arteries of muscle that made this gracilis musculocutaneous flap an integral skin-muscle unit for reliable " primary " use as a local flap to cover the perineum, genitalia, medial thigh, groin, perirectal, and ischial regions. (faoj.org)
  • 3] Hallock demonstrated that the superior medial thigh skin can also be transferred as a free " perforator flap " based on the gracilis musculocutaneous perforators alone, and named this the medial circumflex femoral perforator flap. (faoj.org)
Inferior epigas2
Anterolateral Thigh3
  • The Anterolateral Thigh (ALT) flap was first described by Song, Chen et al in 1984 and has been described as the 'ideal soft tissue flap', due to the versatility of this large, pliable piece of tissue and the resultant minimal donor site morbidity (fig. 4). (beautifulabc.com)
  • Anterolateral Thigh / Vastus Lateralis Flap -- 4. (nshealth.ca)
  • Anterolateral Thigh Perforator Flap -- 9. (nshealth.ca)
Autologous1
  • As with other autologous techniques, the flap is transferred and microsurgically connected to the internal mammary vessels. (beautifulabc.com)
Thigh3
  • The secondary donor-sites for harvesting adipocyte and skin tissues to create a free flap are the regions of: (i) the gluteus maximus muscles, (ii) the medial thigh, (iii) the buttocks, and (iv) the waist of the woman's body. (wikipedia.org)
  • The skin and subcutaneous fat from the inner thigh, just below the groin, can be harvested as a free flap, with or without a piece of the underlying gracilis muscle (fig. 2). (beautifulabc.com)
  • A compound muscle-skin flap combining the medial thigh and underlying gracilis muscle was first used by Orticochea to demonstrate that a " delay " could thereby be avoided while allowing immediate transfer of a large skin flap. (faoj.org)
Procedure2
  • In another method called the free flap procedure, skin, fat, and muscle tissue are removed from your lower belly. (medlineplus.gov)
  • Early identification of insufficiently perfused tissue with the potential to develop ischemia or postoperative necrosis will help guide intraoperative decision making, such as the need for flap revision, tissue resection, or a delayed procedure. (biomedcentral.com)
Necrosis2
  • Fig. 1: (a) Total flap necrosis of the right flap after a bilateral DIEAP flap. (beautifulabc.com)
  • Loss of skin flaps due to ischemia and postoperative necrosis can be catastrophic and may result in an even larger tissue deficit requiring repair. (biomedcentral.com)
Surgical1
Medial4
  • We have confirmed the versatility and safety of the medial circumflex femoral artery perforator flap in this type of injury within the first 24-hours after the injury. (faoj.org)
  • We found the medial circumflex femoral artery perforator flap is one of safe and suitable flap choice in children who have a defect on the distal one third of tibia in the acute period of trauma. (faoj.org)
  • Medial circumflex femoral artery perforator flap, children, fasciocutaneous. (faoj.org)
  • However, the medial circumflex femoral artery perforator (MCFAP) flap has many attributes of an ideal skin flap: 1) it is a moderately large cutaneous flap, 2) the muscle need not be included, 3) the donor site defect is readily concealed by clothing, and 4) the vascular pedicle has a consistent location familiar to most reconstructive surgeons8. (faoj.org)
Free4
  • Free flaps can be categorized into two different types of transplants: isolated and composite. (medscape.com)
  • But this has been largely replaced by its free flap version, where the muscle can be totally or partially saved. (cancer.org)
  • In the pediatric population, it was realized that free flaps could be safely used in the treatment of soft-tissue defects. (faoj.org)
  • 7] In children, donor sites for free flaps are particularly scarce because of the need for a long and reliable vascular pedicle of sufficient size. (faoj.org)
DIEAP1
  • c) The failed right DIEAP flap was removed and replaced by a pedicled Latissimus Dorsi (LD) flap and an implant. (beautifulabc.com)
Resection1
  • 9. Rare case of neglected large sacral Chordoma in a young female treated by wide En bloc resection and Sacrectomy. (nih.gov)
Perforators2
  • Careful design of the flaps to include paraspinal perforators makes them more vascular and reliable. (medscape.com)
  • Excess tissue below the lower gluteal crease can be harvested based on the perforators of the profunda femoris artery. (beautifulabc.com)
Donor site scar3
  • Additionally, the donor site scar covers the entire flank and therefore this flap is only recommended in exceptional circumstances. (beautifulabc.com)
  • The donor site scar lies in the gluteal crease, but may descend over time. (beautifulabc.com)
  • There are two important issues that made the MCFAP flap ideal: 1) it has a specific skin territory that can be reliably harvested and 2) the donor site scar can be easily concealed by the gluteal fold. (faoj.org)
Morbidity1
  • Their pedicles are of enough length to allow for anastomoses out of the site of injury, and the skin islands cover the same area as the traditional flaps, without any donor-site morbidity. (faoj.org)
Muscle4
  • In an extended latissimus dorsi flap, the entire LD muscle, together with additional subcutaneous fat is harvested. (beautifulabc.com)
  • The dissection of this flap is technically challenging and almost always involves harvesting the underlying abdominal oblique muscle. (beautifulabc.com)
  • Angrigiani C, Grilli D, Siebert J. Latissimus dorsi muscolo-cutaneous flap without muscle. (beautifulabc.com)
  • preferred to reconstruct the defects in the distal lower extremity by harvesting the latissimus dorsi muscle flap due to a consistent vascular anatomy and a vascular pedicle of sufficient caliber, even in very small children [6] whereas Van Landuyt, et al. (faoj.org)
Skin1
  • Perforator-pedicled skin island flap for coverage of microvascular anastomoses in myocutaneous flaps in the lower extremity. (doktor-rainer.at)
Defects2
  • Each chapter depicts, in a layered manner, the anatomy of a particular donor site from which flaps are derived and used in head and neck defects, providing systematic steps in understanding the topographical anatomy of the various tissue layers. (nshealth.ca)
  • This beautifully illustrated book, including many basic and advanced flap designs, will be an illuminating reference for all who treat defects in the head and neck area. (nshealth.ca)
Anatomy1
  • The flaps derived from each donor site are presented in detail, with step-by-step instructions in flap design and harvesting techniques based in anatomy. (nshealth.ca)
Include1
  • Such flaps include myocutaneous, osteocutaneous, or innervated myocutaneous flaps. (medscape.com)
Implants1
  • Unlike implants, tissue flaps will change like any other tissue in your body. (cancer.org)
Approach1
  • 8. Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors? (nih.gov)
Site2
  • The flap was then passed up to the chest site where end-to-end anastomoses were performed. (docksci.com)
  • Without undermining, the donor site was closed directly in an almost linear scaring the gluteal fold that can be easily concealed. (faoj.org)