Axial muscle and myocutaneous flaps: a recent concept in wound closure

Until the last decade, the greatest advances in reconstructive surgery have been skin grafting and the advent of pedicle flaps. More recently a new understanding of the discrete vascular anatomy of the skin and other composite tissues has enabled the transfer of these tissues with far more reliability, either locally or--using microvascular techniques--to a distance. The axial and random concept of blood supply of flaps will be outlined. A brief historical background of the development of axial flaps is included. A synopsis of the anatomy, uses and limitations of the commonly used and proven muscle and myocutaneous flaps in our experience is reported. In the final discussion, a new and simple classification of wound closure is proposed which encompasses all the recent developments in this field.