21 - Flaps

Abstract

• Although the surgeon should always first consider primary linear closure of a skin defect, there are many circumstances in which a skin flap may be the ideal choice for reconstruction. • This chapter focuses on random pattern flaps that are divided into advancement, transposition, and rotation flaps. • The following terms are explained to better understand the use of flaps: primary defect, secondary defect, primary motion, secondary motion, flap tip, flap pedicle, key suture, and standing cones. • The advancement flaps include single pedicle flaps, bilateral advancement flaps, T-plasty, L-plasty, and island pedicle flaps. • Rotation flaps include the single rotation flap and the bilateral rotation flap. • Transposition flaps include the rhombic flap and the bilobed flap. • Performing cutaneous flaps is an advanced skill that takes considerable experience to master and should begin under the guidance of a mentor.