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Flashcards in FPRS local flaps Deck (14)
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1
Q

What are the two general categories of local flaps

based on blood supply?

A

● Random (based on subdermal plexus)

● Axial (based on named vessels)

2
Q

Define the term flap delay, and review its

importance.

A

Surgical flap delay is the technique of elevating a flap on a
pedicle and then returning it to the donor site for days to weeks before final transfer. It is believed to condition the
flap to ischemic conditions and/or improve vascular supply of the pedicle.

3
Q

What are the four types of pivotal flaps used in head and neck reconstruction?

A

● Rotation
● Transposition
● Interpolated
● Island

4
Q

Defects of what shape are best suited for closure

with rotational flaps?

A

Triangular defects

5
Q

What is the definition of an interpolated flap?

A

It is a local flap whose pedicle passes over or under
intervening tissue to reach a nonadjacent defect. Typically,
it requires a second stage in which the pedicle is divided.

6
Q

What is the definition of an advancement flap?

A

It is a flap with a linear configuration that closes a defect by sliding toward it.

7
Q

What are the some advantages and disadvantages

of a Z-plasty closure?

A

● Advantages: It can orient scar parallel to resting skin
tension lines, requires minimal excision of normal skin, interrupts forces of scar contracture, and creates broken
line which is less noticeable than a straight line
● Disadvantage: Increases the overall scar length

8
Q

What is the approximate lengthening of the

central limb of a Z-plasty when using 30-degree, 45-degree, and 60-degree angles?

A

25%, 50%, and 75% respectively

9
Q

What are the internal angles of the rhombic flap?

A

60 degrees and 120 degrees

10
Q

Describe the technique of performing a bilobed

flap as originally described by Esser.

A

A double transposition flap, with the first flap oriented 90
degrees to the defect and measuring the same size as the
defect. The second flap is oriented 180 degrees to the
defect and is slightly smaller than the first flap. The first flap
is rotated into the primary defect, the second flap is rotated
into the defect created by the first flap, and the defect
created by the second flap is closed primarily.

11
Q

Describe the Zitelli modification of the bilobed flap.

A

The angle of the first flap is oriented 45 degrees to the
defect, and the second flap is oriented 90 degrees to the
defect. It is designed to keep less tension on repair and
reduce standing cone deformity.

12
Q

Describe the indications for a nasolabial flap in

nasal reconstruction.

A

Superiorly based flaps are best suited for reconstruction of
the lower two-thirds of the nose, including the inferior
dorsum, alae, and tip. Inferiorly based flaps are used for
reconstruction of the columella and nasal floor.

13
Q

What is the blood supply to the paramedian

forehead flap?

A

Supratrochlear artery, located between 1.7 and 2.2 cm

from the midline at the medial aspect of the brow

14
Q

How long after the first stage of a paramedian

forehead flap is the pedicle typically divided?

A

Three weeks; however, in patients who are smokers or have other comorbidities, pedicle division can be delayed