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A Comprehensive Flap Classification: Beyond the Reconstructive Ladder.
Jun Yi Soh1, Lucia Pannuto, Ruben Yap Kannan
1From the Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, United Kingdom.
Annals of Plastic Surgery
|May 24, 2024
Summary
This study introduces a new 3-category classification for free-style flaps, including angiosomal, extra-angiosomal, and neoangiosomal types. This aims to unify terminology and enhance knowledge exchange in reconstructive surgery.
Area of Science:
- Reconstructive Surgery
- Microsurgery
- Vascular Surgery
Background:
- Perforator flap techniques have advanced significantly due to improved vascular imaging and supermicrosurgery.
- Current practices are shifting from traditional angiosomal flaps to customized flap variations.
Purpose of the Study:
- To propose a broadened classification system for free-style flaps.
- To unify existing classifications and facilitate knowledge exchange in reconstructive surgery.
Main Methods:
- Development of a novel 3-category classification for free-style flaps: angiosomal, extra-angiosomal, and neoangiosomal.
- Categorization based on vascular supply and tissue origin.
Main Results:
- The proposed classification includes angiosomal flaps (traditional variations), extra-angiosomal flaps (incorporating different angiosomes), and neoangiosomal flaps (utilizing neoangiogenesis).
- Examples provided include turbocharging/supercharging for extra-angiosomal flaps and venous flow-through/Integra flaps for neoangiosomal flaps.
Conclusions:
- The new classification aims to standardize terminology for free-style flaps.
- This unification is expected to improve the exchange of ideas and techniques among surgeons.
