2. sa reconstructive surgery

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Last updated 1:38 AM on 10/9/26
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6 Terms

1
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when can subdermal plexus flaps be used?

  • can be used anywhere there is loose skin / when there is vascularized skin in the local area of a wound

  • dependent on subdermal plexus at the base of the flap for survival

    • geometric constraints are defined

    • receive blood supply from collateral connections


2
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what are the most common types of subdermal plexus flaps?

  • advancement flap

    • incisions made parallel to wound

    • length of flap should be no greater than 2x the width

  • transposition flap

    • “transpose” skin from one site to another across adjoining skin

  • rotation flap

    • can be used for wounds of many configurations

    • like all local flaps, need to be sure there is enough skin


<ul><li><p><strong>advancement flap</strong></p><ul><li><p>incisions made parallel to wound</p></li><li><p>length of flap should be no greater than 2x the width</p></li></ul></li><li><p><strong>transposition flap</strong></p><ul><li><p>“transpose” skin from one site to another across adjoining skin</p></li></ul></li><li><p><strong>rotation flap</strong></p><ul><li><p>can be used for wounds of many configurations</p></li><li><p>like all local flaps, need to be sure there is enough skin</p></li></ul></li></ul><p></p>
3
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advantages & disadvantages of axial pattern flaps

  • incorporate direct cutaneous artery & vein, terminal branches of which supply blood flow & drainage for subdermal plexus

  • advantages

    • allows for larger flaps with more consistent survival

  • disadvantages

    • locations where these can be created are defined — fewer options than with subdermal plexus flaps

  • can be rotated up to 180 degrees (but no further)


<ul><li><p>incorporate direct cutaneous artery &amp; vein, terminal branches of which supply blood flow &amp; drainage for subdermal plexus</p></li></ul><ul><li><p><strong><u>advantages</u></strong></p><ul><li><p>allows for larger flaps with more consistent survival</p></li></ul></li><li><p><strong><u>disadvantages</u></strong></p><ul><li><p>locations where these can be created are defined — fewer options than with subdermal plexus flaps</p></li></ul></li><li><p>can be rotated up to 180 degrees (but no further)</p></li></ul><p></p>
4
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how is cutaneous perfusion different in cats vs. dogs?

  • dogs have much higher density of tertiary & higher order vessels than cats, esp. on trunk

    • less cutaneous perfusion in cats

  • cats at risk of slower wound healing and greater tissue necrosis with axial pattern flaps than dogs


5
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how are free skin grafts classified?

classified according to thickness

  • full thickness: epidermis & entire dermis

  • split thickness: epidermis & partial thickness of dermis

    • NOT for cats — skin too thin


<p>classified according to thickness</p><ul><li><p>full thickness: epidermis &amp; entire dermis</p></li><li><p>split thickness: epidermis &amp; partial thickness of dermis</p><ul><li><p>NOT for cats — skin too thin</p></li></ul></li></ul><p></p>
6
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where will free grafts “take”?

healthy wound beds

  • smooth surface

  • healthy granulation tissue (well vascularized)

  • tissue must be free from infection & debris