Flaps

Abstract

Flaps are the basis for reconstructive surgery and allow the movement of tissue both locally and distantly, to cover wounds, restore form, and reestablish function. Some flap surgeries have been performed for thousands of years; a clear testament to their efficacy. For today’s plastic surgeon, the understanding of flap anatomy and physiology is an absolutely key. This chapter familiarizes the reader with the history and evolution of flap surgery as well as science behind them. We review the multiple classifications for various flap types. We begin with simple, random skin flaps and work up the reconstructive ladder to composite free flaps. Specific flaps will be discussed, including anatomy, operative techniques, and clinical applications. Finally, we examine various ways flaps may be modified to better meet complex reconstructive challenges. This review contains 17 figures, 4 tables, 1 video, and 36 references.  Key words: Flap, random, pedicled, axial, free, microsurgery, skin, muscle, musculocutaneous, fasciocutaneous, perforator, fabrication, prefabrication, prelamination, supercharging, turbocharging