Plastic Sx

Sure! Here's a list of named flaps categorized by body region, along with their use case scenarios:

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Head and Neck:

1. Washio Flap

   Used for nose reconstruction, particularly nasal lining defects.

2. Abbe Flap

   Employed in lip reconstruction to repair central defects using tissue from the opposite lip.

3. Karapandzic Flap

   Utilized for circular lip defects to preserve oral sphincter function and sensation.

4. Gillies Fan Flap

   Applied in ear reconstruction to recreate the helical rim.

5. Dieffenbach's Flap

   Used for nasal ala reconstruction to repair defects of the nostril margin.

6. Mustardé Flap

   For lower eyelid reconstruction to correct ectropion and retraction.

7. Bakamjian (Deltopectoral) Flap

   Employed in pharyngeal and esophageal reconstruction following head and neck cancer resections.

8. Forehead (Paramedian) Flap

   Classic flap for nasal reconstruction due to its robust vascular supply.

9. Estlander Flap

   Used for commissure and lateral lip defects to restore oral function.

10. Nasolabial Flap

    Applied in intraoral and nasal lining reconstruction.

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Breast:

1. TRAM (Transverse Rectus Abdominis Myocutaneous) Flap

   For breast reconstruction using lower abdominal skin and muscle.

2. DIEP (Deep Inferior Epigastric Perforator) Flap

   Breast reconstruction using abdominal skin and fat while sparing muscle.

3. SIEA (Superficial Inferior Epigastric Artery) Flap

   Alternative to DIEP flap for breast reconstruction with less invasive dissection.

4. Latissimus Dorsi Flap

   Uses back muscle and skin for breast reconstruction.

5. TUG (Transverse Upper Gracilis) Flap

   Employs inner thigh tissue for breast reconstruction.

6. PAP (Profunda Artery Perforator) Flap

   Uses posterior thigh tissue for breast reconstruction.

7. SGAP (Superior Gluteal Artery Perforator) Flap

   Utilizes upper buttock tissue for breast reconstruction.

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Limbs:

1. Radial Forearm Flap

   Used for soft tissue defects in the upper limb and head and neck reconstruction.

2. Fibula (Taylor) Flap

   For mandibular reconstruction and long bone defects.

3. Anterolateral Thigh (ALT) Flap

   Versatile flap for soft tissue reconstruction in limbs and head and neck.

4. Lateral Arm Flap

   Applied in reconstruction of defects in the upper extremity.

5. Gracilis Flap

   Used for functional muscle transfer or soft tissue coverage in limbs.

6. Sural Flap

   Employed for coverage of lower limb defects, especially around the heel.

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Hand:

1. Moberg Flap

   For volar thumb tip injuries to restore length and sensation.

2. Kutler Flap

   Bilateral V-Y advancement flaps for fingertip injuries.

3. Atasoy Flap

   V-Y advancement flap used in distal finger reconstruction.

4. Littler Neurovascular Island Flap

   Used for thumb reconstruction to restore sensation.

5. Foucher Flap

   First dorsal metacarpal artery flap for thumb and finger reconstruction.

6. Cross-Finger Flap

   Applied for dorsal finger defects using adjacent finger skin.

7. Thenar Flap

   Used for fingertip defects by utilizing thenar eminence skin.

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Trunk:

1. Latissimus Dorsi Flap

   For reconstruction of back, chest wall, and breast defects.

2. Reverse Abdominoplasty Flap

   Used for upper abdominal and lower chest wall defects.

3. Thoracoepigastric Flap

   Employed in chest wall and axillary reconstruction.

4. Omental Flap

   Used for chest wall reconstruction and coverage of mediastinal structures.

5. VRAM (Vertical Rectus Abdominis Myocutaneous) Flap

   Applied in pelvic and perineal reconstruction.

6. Ramirez (Component Separation) Flap

   For abdominal wall reconstruction to close large ventral hernias.

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Feel free to use this list for your revision, and best of luck with your studies!

Apologies for missing the Martius Flap earlier. Here are additional named flaps, including the Martius Flap, for your revision:

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Head and Neck:

1. Webster-Bernard Cheek Advancement FlapUsed for large lower lip defects by advancing cheek tissue.
2. Temporalis Muscle FlapApplied in facial reanimation and orbital floor reconstruction.
3. Submental Island FlapUsed for reconstructing oral cavity and facial defects.
4. Faciocervical FlapEmployed in extensive neck and facial skin defects.
5. Parascapular FlapUsed for head and neck soft tissue reconstruction.
6. Masseter FlapApplied in facial reanimation procedures.
7. Nasolabial FlapUsed for intraoral defects and nasal reconstruction.
8. Keystone Perforator Island FlapVersatile flap for various head and neck skin defects.

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Breast:

1. IGAP (Inferior Gluteal Artery Perforator) FlapUses lower buttock tissue for breast reconstruction.
2. TDAP (Thoracodorsal Artery Perforator) FlapMuscle-sparing flap for breast reconstruction from the back.
3. LICAP (Lateral Intercostal Artery Perforator) FlapUsed for partial breast reconstruction from lateral chest wall.
4. AICAP (Anterior Intercostal Artery Perforator) FlapUtilizes anterior chest wall tissue for breast reconstruction.
5. EFAP (Extended Free Abdominal Perforator) FlapFor large-volume breast reconstruction using abdominal tissue.

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Limbs:

1. Medial Sural Artery Perforator (MSAP) FlapUsed for soft tissue defects in limbs and head and neck.
2. Anteromedial Thigh FlapAlternative to ALT flap for soft tissue coverage.
3. Free Vastus Lateralis Muscle FlapEmployed in extensive limb soft tissue defects.
4. Groin FlapUsed for hand and forearm reconstruction.
5. Fibular Osteocutaneous FlapFor reconstruction of long bone defects and mandibular reconstruction.
6. Toe-to-Hand TransferUsed for digit reconstruction, especially thumb.
7. Medial Plantar FlapApplied in heel and foot sole reconstruction.

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Hand:

1. Moberg Advancement FlapFor volar thumb defects to preserve sensibility.
2. Atasoy V-Y FlapUsed in fingertip injuries with volar tissue loss.
3. Kutler Lateral V-Y FlapsFor transverse fingertip amputations.
4. Littler's Neurovascular Island FlapTransfers sensate tissue to thumb from the ulnar side of the ring finger.
5. First Dorsal Metacarpal Artery (FDMA) FlapUsed for thumb and finger reconstruction.
6. Reverse Homodigital Island FlapApplied in distal digital defects.
7. Cross-Finger FlapUsed for dorsal finger defects, transferring skin from adjacent finger.

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Trunk:

1. Ramirez Component Separation TechniqueUsed in abdominal wall reconstruction to close large midline defects.
2. VRAM (Vertical Rectus Abdominis Myocutaneous) FlapApplied in pelvic and perineal reconstruction.
3. Omental FlapUsed for chest wall reconstruction and mediastinal coverage.
4. Thoracoabdominal FlapEmployed in extensive chest wall defects.
5. Latissimus Dorsi Flap (Reverse)Used for lumbar and lower back defects.
6. Gluteal Fold FlapApplied in sacral and ischial pressure sore coverage.

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Pelvis/Perineum:

1. Martius FlapA labial fat pad flap used in urogenital reconstruction, specifically for urethrovaginal and vesicovaginal fistulas.
2. Singapore Flap (Pudendal Thigh Flap)Used in vulvar, vaginal, and perineal reconstruction.
3. Gracilis Muscle FlapApplied in perineal and vaginal reconstruction, also for anal incontinence.
4. Rectus Femoris FlapUsed for pelvic floor and perineal defects.
5. Deep Inferior Epigastric Artery Perforator (DIEP) FlapCan be used for perineal reconstruction in certain cases.

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Feel free to use this expanded list for your last-minute revision. Good luck with your studies!

Cormack & Lamberty

Fasciocutaneous Flaps

• Fasciocutaneous flaps include a fascial component that enhances blood supply through a network of subfascial, fascial, and suprafascial vessels.

• Classification (Cormack and Lamberty, 1984):

  • Type A: Multiple perforators, direct or indirect (e.g. Pontén flap).
  • Type B: Single perforator, direct and aligned with flap axis (e.g. scapular or parascapular flaps).

  • Type C: Segmental perforators from the same source vessel (e.g. radial forearm and lateral arm flaps).

  • Type D: Like Type C, but raised as an osteomyofasciocutaneous flap (e.g. free fibular flap).

  

  

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Mathes & Nahai

Muscle and Musculocutaneous Flaps

• In muscle flaps, the motor nerve is paired with a vascular pedicle, often the main blood source.
• Dominant pedicle: Can sustain the entire muscle.
• Minor pedicle: Can only sustain part of the flap.
• The skin in a musculocutaneous flap is supplied by perforators.

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Muscle Flap Classification (Mathes and Nahai, 1981)

• Type I: Single vascular pedicle (e.g. tensor fascia lata, gastrocnemius).
• Type II: One dominant pedicle with one or more minor pedicles (e.g. gracilis, biceps femoris, sternocleidomastoid, soleus, trapezius).
  • The flap cannot survive on minor pedicles alone.
• Type III: Dual dominant pedicles (e.g. gluteus maximus, pectoralis minor, rectus abdominis, serratus anterior, temporalis).
• Type IV: Segmental pedicles (e.g. flexor hallucis longus, sartorius, tibialis anterior).

• Type V: Dominant pedicle with several smaller segmental pedicles (e.g. latissimus dorsi, pectoralis major).

  • The flap can survive on minor pedicles alone.

  

Van der Woude Syndrome

• Inheritance: Autosomal dominant.
• Key Features:
  • Cleft Lip/Palate (CL/P).
  • Lower lip pits (a distinctive feature).

• Genetic Mutation: Mutation in the IRF6 gene.

  

Stickler Syndrome

• Inheritance: Autosomal dominant.
• Key Features:
  • Isolated Cleft Palate (CP).
  • Eye defects: Myopia, retinal detachment, cataracts.
  • Sensorineural hearing loss.
  • Joint abnormalities: Early-onset arthritis, hypermobility.
• Genetic Mutation: Mutation in a procollagen gene.
• Association:
  • Most common syndrome associated with Pierre Robin sequence:
    • Micrognathia (small jaw).
    • Glossoptosis (downward displacement of the tongue).
    • Respiratory distress.

Hallmarks of Unilateral Cleft Lip Deformity:

1. Depression of the Nasal Tip:
   • Nasal tip appears lower on the cleft side.
2. Flaring of the Alar Base:
   • The alar base (side of the nostril) flares outward on the cleft side.
3. Deviation of the Caudal Septum and Columella:
   • The caudal septum and columella deviate toward the non-cleft side, affecting nasal symmetry.
4. Deficient Lip Height:
   • The philtral column (area between the nose and upper lip) is shortened on the cleft side.
5. Cephalad Rotation of Cupid's Bow:
   • The cupid’s bow (the upper lip’s shape) is rotated upward on the cleft side, causing asymmetry in lip shape.