What are the characteristics of local skin flaps?:
Composition:
Local flaps consist of skin and subcutaneous tissue.
They may also include deeper layers like muscle or fascia, depending on the specific type of flap.
Blood supply:
The flap remains connected to its original blood supply, which is crucial for its survival.
This is a key difference from skin grafts, which rely on the recipient site for blood supply.
Mobility:
The flap is partially cut and moved to an adjacent area, typically by rotating, advancing, or transposing it. They are limited in movement by the attached blood supply carrying tissue, called the pedicle.
Types:
Common types include rotation flaps, advancement flaps, and transposition flaps, each named for how the tissue is moved.
When are Local flaps used?:
Facial reconstruction:
Particularly and commonly useful for repairing defects after skin cancer removal on the face, where matching skin colour and texture is crucial.
Lower extremity reconstruction:
Can be used to cover defects on the leg or foot.
Hand surgery:
Used to cover defects on the hand where skin elasticity and sensation are important.
Breast reconstruction:
Local flaps can be used for partial breast reconstruction or to refine the results of other reconstructive techniques.
Pressure sore repair:
Can provide durable coverage for chronic wounds like pressure ulcers.
What are the advantages of local flaps?:
- Good color and texture match, as the skin comes from an adjacent area.
- Maintained blood supply, leading to better survival rates than skin grafts.
- Can provide a single-stage reconstruction for many defects.
- Often results in less noticeable scarring than skin grafts.
- Can bring healthy, well-vascularized tissue into an area of compromised healing.
Considerations for use:
- Size of the defect: Local flaps are typically used for small to medium-sized defects.
- Location: The surrounding tissue must have enough laxity to allow movement without excessive tension.
- Blood supply: The vascular anatomy of the area must be carefully considered to ensure flap survival.
- Patient factors: Overall health, smoking status, and other conditions that might affect wound healing are important considerations.