Sliding Subcutaneous-Pedicle Flaps to Close a Circular Defect

Trevaskis, Allan E.; Rempel, J; Okunski, Walter J.; Rea, Michael C.

doi:10.1097/00006534-197008000-00008

Cited by 65 publications

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“…They change the two scar lines into one central zig-zag line by elongating the columella and the nasal tip with the prolabium and closing the donor site with a nasolabial ap (10). Subcutaneous pedicle aps, including nasolabial aps, have been used more and more often since the 1960s (2,6,14,15). The blood supply of the subcutaneous pedicle nasolabial aps was studied more profoundly in the 1970s by Herbert and Harrison (3).…”

Section: Resultsmentioning

confidence: 99%

Unilateral Superiorly-Based Nasolabial Island Flap for the Reconstruction of the Philtrum

Shipkov

Anastassov

Simov

2002

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Section: Resultsmentioning

confidence: 99%

Unilateral Superiorly-Based Nasolabial Island Flap for the Reconstruction of the Philtrum

Shipkov

Anastassov

Simov

2002

Scandinavian Journal of Plastic and Reconstructive Surgery and

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“…Small lower leg defects between 10 and 35 mm are candidates for a local subcutaneous flap, including bilateral V-Y advancement flaps. Most of these flaps use a randompattern subcutaneous pedicle [3,4,12,13], and attempts have been made to include the deep fascia, hoping for better perfusion. Hallock [14] reported so-called random fasciocutaneous flaps that included adequate deep fascia for small or moderate-sized defects.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Aesthetic Results of Small Bilateral V-Y Advancement Flaps in the Extremities and Back

Kim

Choi

Moon

et al. 2017

Arch Aesthetic Plast Surg

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INTRODUCTIONThe most common pattern used for the management of skin tumors or circular skin defects is elliptical excision and closure. This technique is simple and easy, but healthy skin in the corner of the defect is also removed, and it can leave a central depression with dog ears at its ends. Furthermore, these problems are exacerbated when an elliptical excision is performed in a region with insufficient skin redundancy, such as the pretibial region or the heel.Bilateral V-Y advancement flaps have been widely used to reconstruct facial defects [1,2]. These flaps simplify and ease mapping and the operative procedure. Moreover, they show good color and texture harmony because nearby tissue is used. In this technique, triangular flaps based on nutrient pedicles in subcutaneous tissue are usually elevated. Although these random flaps have been proven to have excellent vascularity in the facial region [3,4], repair of the extremities using these flaps has been regarded as more difficult than reconstructions elsewhere in the body because of poor blood supply and the pressure effects of dependency [5]. We performed bilateral V-Y advancement flaps in 24 patients with small Background Random type small V-Y advancement flap is widely used for facial reconstruction with advantages including good color and texture match. However, the flap is not as widely used in the extremities and back as in the face because of apprehension of the relatively poor vascularity as a risk factor of flap necrosis. We used a small bilateral V-Y advancement flap for the repair of extremity and back defects from various causes. Competent clinical outcomes are described. Methods Between 2007 and 2014, 24 patients (48 flaps) with skin defects in the upper or lower extremities and back were enrolled. The site of the defect was on back (n=6), forearm (n=7), upper arm (n=2), lower leg (n=5), thigh (n=3), and axilla (n=1). Results Among the 48 flaps, 47 survived (no event: 42 flaps, total necrosis: 1 flap, partial necrosis: 5 flaps). All partial necrotized flaps healed in 3-4 weeks with conservative care. However, debridement and skin grafting was required for the total necrosis flap. One total necrosis and two partial necroses occurred on the anterolateral side of the lower leg. Two partial necroses occurred on the paraspinal area. Conclusions Contour deformities including central depression and the dog-ear deformity were not observed. Small bilateral V-Y advancement in the extremity and back could be a safe and useful flap, if thick subcutaneous fat and subcutaneous plexus were saved. But areas with thin subcutaneous fat layer, such as the anterolateral lower leg, are poor candidates and carry the increased risk of improper subcutaneous pedicle circulation.

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“…[24][25][26][27][28] Although design and harvesting of a V-Y advancement flap is simple, its limited mobility has been a challenging problem, especially for the treatment of relatively large defects located in regions where subcutaneous tissue is not sufficient. To solve the mobility problem of the flap, perforator-based V-Y advancement flaps were used by some authors, especially for leg and forearm defects.…”

Section: Discussionmentioning

confidence: 99%

The Pacman Perforator-Based V-Y Advancement Flap for Reconstruction of Pressure Sores at Different Locations

Bonomi

Salval

Brenta

et al. 2016

Annals of Plastic Surgery

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The V-Y Pacman perforator-based advancement flaps are safe and very effective for reconstruction of pressure sores at various regions. The advantage of our modification procedure include shorter operative time, lesser pedicle dissection, low donor site morbidity, good preservation of muscle, and offers remarkable excursion to the V-Y flap, which make the V-Y Pacman perforator-based flaps an excellent choice for large pressure sore coverage.

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Sliding Subcutaneous-Pedicle Flaps to Close a Circular Defect

Cited by 65 publications

References 0 publications

Unilateral Superiorly-Based Nasolabial Island Flap for the Reconstruction of the Philtrum

Unilateral Superiorly-Based Nasolabial Island Flap for the Reconstruction of the Philtrum

Feasibility and Aesthetic Results of Small Bilateral V-Y Advancement Flaps in the Extremities and Back

The Pacman Perforator-Based V-Y Advancement Flap for Reconstruction of Pressure Sores at Different Locations

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