KEY NOTES CHAPTER 1: GENERAL PRINCIPLES - Classification of flaps Flashcards Preview

FRCS Plastic Surgery > KEY NOTES CHAPTER 1: GENERAL PRINCIPLES - Classification of flaps > Flashcards

Flashcards in KEY NOTES CHAPTER 1: GENERAL PRINCIPLES - Classification of flaps Deck (10)
Loading flashcards...
0
Q

How do you classify flaps by circulation?

A

Random

Axial

  • direct (e.g. deltopectoral - IMA, groin - SCIA)
  • fasciocutaneous,
  • musculocutaneous,
  • venous.
1
Q

How do you classify flaps?

A
Circulation.
Composition.
Contiguity.
Contour.
Conditioning.
2
Q

What is the Cormack and Lamberty classification of FC flaps?

A

Type A - multiple FC vessels entering from base of flap e.g. Ponten.
Type B - single axial FC vessel e.g. scapular / parascapular flap, perforator DC flaps of lower leg.
Type C - multiple small perforating vessels from deep artery running along a fascial septum between muscles e.g. radial forearm, lateral arm flaps.
(Type C with bone).

3
Q

What is the Mathes and Nahai classification of FC flaps?

A

Type A - direct cutaneous pedicle. e.g. groin, SIEA, dorsal metacarpal artery flaps.
Type B - septocutaneous. e.g. scapular, parascapular, lateral arm, PIA flaps.
Type C - musculocutaneous. e.g. median forehead, nasolabial, ALT (usually).

4
Q

How are muscle and musculocutaneous flaps classified?

A

Mathes and Nahai (1981 PRS).

  1. single pedicle.
  2. dominant and minor (unreliable) pedicles.
  3. 2 dominant.
  4. multiple segmental.
  5. 1 dominant, secondary segmental pedicles (can raise on either).
5
Q

Give examples of each.

A
  1. gastrocnemius, TFL, ADM.
  2. trapezius, soleus, gracilis.
  3. rectus abdominis, pectoralis minor, gluteus maximus.
  4. sartorius, tibialis ant, long toe extensors and flexors.
  5. latissimus dorsi, pec major.
6
Q

How are venous flaps classified?

A

Thatte and Thatte.

  1. single venous pedicle.
  2. venous flow through flaps.
  3. arterialised venous flap (AVA proximally).
    e. g. saphenous flap (based on LSV), unpredictable, prone to congestion.
7
Q

How are flaps classified by composition?

A
Cutaneous.
Fasciocutaneous.
Fascial.
Musculocutaneous.
Muscle.
Osseocutaneous.
Osseous.
8
Q

How are flaps classified by contiguity?

A

Local - donor site adjacent to defect.
Regional - within the same region.
Distant.

9
Q

How are flaps classified by contour (how they are transferred into defect)?

A
  1. Advancement.
  2. Transposition.
  3. Rotation (in reality, flaps are rotated and transposed, i.e. pivot flaps).
  4. Interpolation (under or above intervening piece of tissue).
  5. Crane principle - transforms an ungraftable bed to graftable.

Decks in FRCS Plastic Surgery Class (63):