tissue is transferred from a donor site to recipient site along with its corresponding blood supply.

• better cosmetic results than skin grafting (skin tone and texture usually better matched)
• reduced chance of failure in comparison to skin grafts.

possible complications

• flap failure
  • Arterial: pallor, reduced perfusion. requires immediate surgical intervention
  • venous: venous congestion. conservative management

Classification

<aside> 💡 Based on tissue type, blood supply or location

</aside>

• Tissue Type: based on compositions utilised in the flap, including cutaneous flap, fasciocutaneous flap, musculocutaneous flap, or muscle flaps

• Blood Supply:

  • Axial flap – a designated fasciocutaneous artery that runs beneath the flaps longitudinal axis
  • Random flap – no designated named artery that provides blood supply to the flap; blood supply via the subdermal plexus
  • Pedicled (or perforator) flap – the tissue is completely raised on a named vessel from the donor site and then transferred to the recipient site; this can be as a pedicled flap or free flap

• Location:

  • Local flaps harvested from a contiguous site and are commonly used for facial defects, fingertip injuries, or defects on the limb. These can be further classified into:
    • Advancement flap – The skin is moved directly forward
    • Rotation flap – The skin is rotated around a pivot point to cover an adjacent defect
    • Transposition flap – Moves laterally in relation to the pedicle to cover an adjacent defect
  • Regional (or pedicled) flaps are harvested from the same anatomical region but not directly adjacent. The attached skin (or pedicle) will be tunnelled under the intact tissue, or laid over intact skin forming what is known as a skin bridge, which can then detached from the donor site in a second procedure.
  • Free (or distant) flaps are harvested from a different anatomical region entirely. The tissue and named fasciocutaneous artery are separated from the donor site before being reattached at the recipient site using microsurgical techniques.