[Subcutaneous peduncle flaps in reconstructive surgery]

Among the varying forms of cutaneous flaps, V-Y flaps are finding an increasingly wide application in reconstructive surgery. Their use has been extended, depending on the cutaneous area in question, to various sizes of loss of substance. According to the type of tissues involved, the peduncle may be adipose, fascial or muscular. Vascularisation is random, but in those cases in which the base consists of muscle fascia an axial type is used since the peduncle generally corresponds to a well-known artery. V-Y flaps can repair defects measuring upto 5 cm in diameter and also guarantee a rotation of upto 90 degrees. The authors report their experience of 134 cases in which V-Y flaps were used in the reconstruction of loss of substance localised on the face, upper limbs, trunk, gluteal region, ear, leg and foot. The underlying pathologies consisted mainly of skin cancers, loss of substance following injury, scar retractions, syndactylia, decubitus ulcers in the gluteal region and a trophic foot ulcer. It was not necessary to re-operate any patient owing to problems linked to retraction or the unsightly appearance of residual scars. In the past V-Y flaps were indicated above all for the reconstruction of loss of face substance, but their use today has been extended to other districts. The authors highlight the advantages offered by V-Y flaps: ease and rapidity of use, the characteristics of the skin graft are identical to that removed, and the preservation of sensitivity.