Structure and construction: the system of skin flaps

Area of Science:

• Plastic Surgery
• Vascular Anatomy
• Surgical Innovation

Background:

• Skin flap complexity has increased, hindering standardized classification.
• Previous studies focused on skin blood circulation, leading to advanced flap designs.
• A need exists to understand the underlying structure of complex flaps.

Purpose of the Study:

• To analyze the internal system of skin flaps.
• To establish a connection between flap construction and vascular architecture.
• To develop a classification system based on fundamental flap types.

Main Methods:

• Analysis of flap construction and vascular patterns.
• Identification of elementary flap types based on vascular structure.
• Examination of how complex flaps are composed from elementary types.

Main Results:

• A direct link between flap construction and vascular structure was identified.
• Three elementary flap types were defined based on fundamental construction and vascular patterns.
• Complex flaps were found to be combinations (parallel, sequential, or both) of these elementary types.

Conclusions:

• A new classification of flaps is proposed, based on three elementary vascular types.
• Maintaining the continuity of elementary vascular patterns is crucial for flap viability.
• This understanding facilitates the design and application of complex reconstructive flaps.