A review of flaps and their uses in reconstructive surgery

Abstract

The field of reconstructive surgery is rapidly advancing with advances in the techniques of anatomical dissection, understanding of the neurovascular physiology, and improvements in surgical instrumentation. Flaps are composite units of tissue which have their own blood supply or an intact arteriovenous system to receive vascular inflow when transferred to a site of defect. Due to a wide array of flaps being used in reconstructive surgery, numerous terminologies can be found in use by reconstructive surgeons. Skin flaps are flaps that are composed of skin and subcutaneous tissues. Composite flaps are those which contain more than one component within the flap substance, and perforator flaps are those based on a cutaneous perforator. The angiosome concept has aided in understanding the vascular basis of flaps and increases their utility. Further research and insights are needed at the moment to have a finer understanding of the tissue neurovascular anatomy and flap behavior.