The Flap Surgery blog is an online educational tool for patients, medical students, nurses, physician assistants, general surgery residents, plastic & reconstructive surgery residents and physicians from other medical specialties who wish to become familiar with some of the more common anatomical flaps used in plastic & reconstructive surgery.
Wednesday, August 21, 2013
Thursday, June 13, 2013
Hernia Reconstruction with Component Separation and Tensor Fascia Lata Flap
Massive hernias of the abdominal wall may require multiple stages to repair. When repairing hernias, stable soft tissue coverage is important. In patients who have developed a loss of domain because of prior open wounds, a component separation may be employed to recruit more tissue to facilitate closure. Occasionally, in large tumors of the abdominal wall, the plastic and reconstructive surgeon will use the tensor fascia lata muscle from the thigh to close the wound.
The tensor fascia lata is harvested and exposed and then rotated towards the abdomen. The upper border of the abdominal fascia can be closed and the inferior portion can be closed as an underlay with the tensor fascia lata.
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Thursday, January 24, 2013
Gastrocnemius Flaps for Coverage of Antibiotic Spacers for Internal Total Knee Replacement
Gastrocnemius flaps are commonly used flaps to cover the proximal aspect of the tibia or distal knee joint. Gastroc flaps have become one of my favorite flaps over the years as they can be readily harvested through an extension of a previous incision.
Care should be taken when harvesting the flap to preserve the saphenous vein as this can significantly help the edema that is often present in the re-operative lower extremity. Furthermore, appropriate preservation is helpful as it may be used as a back-up for venous outflow if free tissue transfer is needed.
I find that one of the most helpful maneuvers in the gastroc flap is to remove the fascia from the under surface of the muscle. This allows for the exposure of a raw surface to adhere to the bone or antibiotic spacer. The raw muscle allows greater contact and exposure of surface area to the underlying object.
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