Flow-through flaps: a review of current knowledge and a novel classification system

Area of Science:

• Plastic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Flaps are crucial for soft-tissue reconstruction, with flow-through flaps offering unique advantages.
• The concept involves anastomosing both ends of a free flap's vascular pedicle for continuous blood flow.
• First described in 1983, flow-through flaps enable simultaneous reconstruction of soft tissue and vascular defects.

Purpose of the Study:

• To provide an organized review of flow-through flaps.
• To classify flow-through flaps based on inflow, outflow, and vascular conduit.
• To create a reference guide for selecting appropriate flow-through flaps.

Main Methods:

• Literature review of existing case reports and series.
• Classification system developed based on vascular pedicle characteristics.
• Discussion of flap physiology and current applications.

Main Results:

• Identified inconsistent nomenclature in current literature.
• Proposed a classification system for flow-through flaps.
• Summarized various flap types and their applications.

Conclusions:

• Flow-through flaps are increasingly valuable for complex reconstructions, especially in ischemic extremities and post-oncologic defects.
• Standardized classification will improve understanding and selection of these flaps.
• Advancements in microsurgery enhance the utility and creative application of flow-through flaps.