A brief historical review of flaps and burn reconstruction

Thermal, chemical, and electrical injuries contribute to some of the most disabling and deforming wound injury patterns. These challenges, ultimately cared for by burn and reconstructive specialists, require an evolution in the understanding of functional and aesthetic prioritization, 3-dimensional geometric rearrangement of tissues, anatomic considerations of neurovascularized constructs, as well as the development of fundamental technical skills. Flaps, generally defined as tissue constructs, transferred along with a defined vascular supply are considered principle elements in the armamentarium of the reconstructive specialist. The transfer and design of these flaps can augment most tissue type deficits, protect or transfer functional neurovascular and musculotendinous structures, and provide bone and durable soft tissue elements to restore both form and function. The history of flap construct and reconstruction precedes available written text and spans independent cultural, temporal and geographic divides. Several key flaps currently utilized in burn and reconstructive surgery will be reviewed with some historical context provided. A comprehensive review of the history of flaps in reconstructive surgery certainly exceeds the scope of any simplistic chapter or text.