LOCAL FLAP

Definitions

A flap is a piece of tissue with a blood supply that can be used to cover an open wound. A flap can be created from skin with its underlying subcutaneous tissue, fascia, or muscle, either individually or in some combination. Depending on the reconstructive requirements, even bone can be included in a flap.

A local flap implies that the tissue is adjacent to the open wound in need of coverage, whereas in a distant flap, the tissue is brought from an area away from the open wound.

Local flap coverage of a wound is the next higher rung up the reconstructive ladder after a skin graft. Examples of wounds that require flap coverage include wounds with exposed bone, tendon, or other vital structure and large wounds over a flexion crease, for which a split-thickness

skin graft or secondary closure would result in tight scarring.

Donor site: where the flap originates.

Recipient site: the open wound/soft tissue defect in need of coverage.

Pedicle: the blood supply of the flap (i.e., its arterial inflow and venous outflow). The pedicle varies from a wide bridge of tissue (skin, subcutaneous tissue, muscle, or some combination) to an isolated artery and vein.

Most local flaps can be classified as either (1) skin flaps, which are skin and subcutaneous tissue with or without the underlying fascia, or (2) muscle flaps, which are created from a muscle with or without the attached overlying skin.