Atypical Island Flaps

Abstract

Deep tissue injuries have many functional and cosmetic features that pose limits on available treatment options, especially when bones, joints, or tendons are exposed. Such instances have been treated using various types of flaps, including local, distant, island, and free flaps. However, conventional flaps may be inappropriate in some cases due to limitations in size, arc of rotation, flap bulkiness, sacrifice of an artery, long operation time, need for microsurgery techniques, etc. Possible promising alternatives for management of such scenarios are arterial and venous island flaps. Unlike conventional axial pattern flaps, they rely on the arterial or venous system alone for flap perfusion. The atypical flaps have many advantages over more conventional flaps. There is no need for a microsurgical procedure and donor site morbidity is minimal. These relatively simple and time-saving procedures are done in one stage, avoid uncomfortable immobilization, and shorten the period of hospital care. Further advantages include excellent sensory restoration is possible and cosmetic results are acceptable. These atypical artery- or vein-only island flaps are particularly versatile in hand coverage. The aim of this chapter is to report the usefulness and postoperative results of arterial and venous island flaps for coverage of deep tissue defects.