Flap classification

Methods of classification

• Composition– Skin +/- fascia– Muscle (+/- innervation)– Bone– Omentum / viscera– Composite

• Proximity to defect• Method of movement• Vascular anatomy

Proximity to defect

• Local• Regional• Distant• Free

Arterial supply of the skin

Method of movement• Advancement• Transposition• Rotation• Interpolation• Waltzing

Fascio/cutaneous flaps

Type AType A

Direct cutaneous Direct cutaneous pediclepedicle

Type BType B

Fasciocutaneous Fasciocutaneous pediclepedicle

Type CType C

Musculocutaneous Musculocutaneous pediclepedicle

Deep external pudendalDeep external pudendal

Digital arteryDigital artery

Dorsal metacarpalDorsal metacarpal

GlutealGluteal

GroinGroin

Lateral thoracicLateral thoracic

PudendalPudendal

SaphenousSaphenous

ScalpScalp

ForeheadForehead

Superficial external Superficial external pudendalpudendal

Superficial inferior epigastricSuperficial inferior epigastric

SuralSural

Temporoparietal fasciaTemporoparietal fascia

ALTALT

Anterior + posterior tibialAnterior + posterior tibial

DeltoidDeltoid

Dorsalis pedisDorsalis pedis

Inferior cubital (antecubital)Inferior cubital (antecubital)

Lateral + medial armLateral + medial arm

Lateral + medial plantarLateral + medial plantar

Lateral + medial thighLateral + medial thigh

PeronealPeroneal

Posterior interosseousPosterior interosseous

Radial + recurrentRadial + recurrent

ScapularScapular

UlnarUlnar

ALTALT

DeptopectoralDeptopectoral

NasolabialNasolabial

Median foreheadMedian forehead

Thoracoepigastric Thoracoepigastric (transverse abdominal)(transverse abdominal)

Transverse backTransverse back

Musculocutaneous flaps

I One I One vascular vascular pediclepedicle

II Dominant II Dominant vascular vascular pedicle + pedicle + minor minor pediclepedicle

III Two III Two dominant dominant pediclespedicles

IV IV Segmental Segmental supplysupply

V Dominant V Dominant vascular vascular pedicle + pedicle + secondary secondary segmental segmental pediclespedicles

ColonColon

JejunumJejunum

DCIADCIA

GastrocsGastrocs

TFLTFL

Vastus Vastus lateralislateralis

GracilisGracilis

HamstringsHamstrings

SoleusSoleus

SCMSCM

TrapeziusTrapezius

Omentum Omentum Gluteus Gluteus maximusmaximus

Pec minorPec minor

RectusRectus

Serratus Serratus anterioranterior

TemporalisTemporalis

EDL, EHL, EDL, EHL, FDL, FHLFDL, FHL

Tibialis antTibialis ant

SartoriusSartorius

External External obliqueoblique

FibulaFibula

Lat dorsiLat dorsi

Pec majorPec major