Principle of Wound coverage Flap Surgery - AADO

FLA

• Skin flap

– Subcutaneous tissues
– Random pattern 1:1 le
– Pedicle

• Major artery
• Perforator
• Could be of high length
• Venous drainage of fla

– Free

• microsurgery

APs

s
ength to width ratio

h to width ratio
ap

Cho

• Muscle flap

– Cavity to fill
– Bring in vascularity

• Myocutaneous flap

– Donor site morbidity

• Composite tissue tra

– Skin, Muscles, Fascia
Blood vessels, Perios
digits

oices

ansfer

a, Tendons, Nerves,
steum, Bone, Whole

Decision

• Tissues requi
• Scarring and
• Donor site mo
• Patient accep
• Surgeon facto

n Making

ired
flap appearance
orbidity
ptance
or

How to choose th
Recipie

• Where
• Size
• Shape
• Presence of contract

• Nature

he correct flap ?
ent site:

ture

Nature of re

• Clean / contaminated
• Fresh / Granulation b
• Tissue lost : muscle,

– Thickness
– Support
– Sensation
– motion

• Tissue status surroun
circulation, adjacent

ecipient site

d / infected ?
bed ?

tendon, nerve, bone

nding the wound :
joint

Choice o

• Healthy with no previ
irradiation

• Minimal disturbance
function after flap har

• Stable arterial supply
• Diameter of artery, le
• Cutaneous nerve

of Donar

ious surgery, injury ,

in appearance and
rvest
y, few variation
ength of pedicle

Different catego

• Blood supply

– Random or Axial

• Method of transfer

– Pedicle or Free

• Location

– Local, regional, distan

ories of FLAPs

nt

VY Adva

ancement









Local latera

al arm flap









Muscle

e flaps

Gastronemius

s Muscle flap





Flap fo

or NF

Latissimus dorsi
fla

i myocutaneous
ap

Pedicl

le flap

PIA (posterior in

nterosseous flap)





Radial For

rearm Flap

Radial For

rearm Flap

Foucher (1s

st DMA flap)

Sapheno

ous flap