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What Is Fasciocutaneous Flap Surgery?

What is a fasciocutaneous flap?

Fasciocutaneous flap surgery is the excision of a skin and tissue flap for positioning over skin burns, injuries or other reconstructive sites. This specific flap technique preserves extra tissue and blood vessels in addition to skin.
Fasciocutaneous flap surgery is the excision of a skin and tissue flap for positioning over skin burns, injuries or other reconstructive sites. This specific flap technique preserves extra tissue and blood vessels in addition to skin.

Fasciocutaneous flaps are tissue flaps, which consist of skin and underlying tissues including fascia (a collagen-rich lining tissue). Fasciocutaneous flaps are used to provide coverage to bones and tendons in surgery when skin graft coverage is insufficient.

Advantages of using fasciocutaneous flaps over other flaps:

  • Fasciocutaneous flaps are less bulky so they are used for most of the surgery.
  • There is no functional loss with fasciocutaneous flaps, unlike muscle flaps.
  • They are quick and reliable in healthy patients.
  • It is easy to design and construct large fasciocutaneous flaps that are safe due to good circulation.
  • The operating time is relatively short with an experienced surgeon, and no extra equipment is needed.

Disadvantages of fasciocutaneous flaps include that they are less resistant to infections compared to muscle flaps.

What are the types of fasciocutaneous flaps?

Cosmetic surgeons classify fasciocutaneous flaps based on blood vessels:

  • Type A: Multiple perforations extending throughout the length.
  • Type B: A single perforation which is moderate in size.
  • Type C: Multiple, small perforations.
  • Type D: Similar to Type C, but also involves a portion of an adjoining muscle and bone.

What are the different kinds of fasciocutaneous flaps?

Based on where fasciocutaneous flaps are harvested, there are different flaps used:

  • Fasciocutaneous flaps of the head, neck and trunk (torso)
    • Temporoparietal flap: It is situated above the membrane covering the temporalis muscle (a muscle on the side of the head). It is used to cover defects of the ear and the upper portion of the face.
    • Scapular and parascapular flaps: Taken from the shoulder. They are used to cover hand wounds.
  • Fasciocutaneous flaps of the legs:
    • Groin flap: Taken from the pubic area; useful in covering upper leg defects.
    • Lateral and medial thigh flap: Taken from the sides of the thigh.
    • Anterolateral thigh flap: Taken from the front of the thighs.
    • Posterior or gluteal thigh flap: Taken from the back of the thigh or near the biceps.
    • Dorsalis pedis flap: Taken from the upper portion of the feet.

What are the complications involved in using fasciocutaneous flaps?

Complications of fasciocutaneous flaps include:

  • Numbness on the site where the flaps are placed
  • Infections
  • Complete or partial paralysis

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Reviewed on 6/8/2020
References
Medscape Medical Reference
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