Free abdominal flaps: variations in design and application to soft tissue defects of the head

The use of free abdominal flaps in the reconstruction of soft tissue defects of the head is described. The vascular supply of these flaps is from perforating vessels stemming from the deep inferior epigastric vessels. Variously modified flaps can be elevated in the same way as vascular island flaps, with a small part of the rectus abdominis muscle and deep inferior epigastric vessels attached. There are three main types of such flaps; a transversely-shaped type, a blunt U-shaped type, and an L-shaped type. The technique has been successfully used for electrical injury, surgically-created defects, and traumatic soft tissue losses.