Local Flap Reconstruction

Anthony Penington, Plastic and Reconstructive and Hand Surgeon, Senior Lecturer in Surgery, The University of Melbourne. Member of the Australian Society of Plastic Surgeons. Department of Surgery, St Vincents Hospital. Consultant plastic surgeon to the Skin and Cancer Foundation Melbourne. Deputy Director of the Bernard OBrien Institute of Microsurgery.

ForewardPrefaceAchknowledgmentsPart A PriniciplesChapter 1 1.0 Introduction1.1Aims of reconstruction1.2 Defining Aims of flap surgery1.3Excision and direct closure1.4Blood supply of the skin1.5 Flaps in continuity1.6 Island flaps1.7Designing a flap for reconstruction1.8Surgical technique 1.9 A simple skin flap reconstruction: the rhomboid flapPart B Case StudiesChapter 2Flaps in continuityCase 2.1Transposition flap: forearmCase 2.2Transposition flap: neckCase 2.3Transposition flap: groinCase 2.4Transposition flap: foreheadCase 2.5Transposition flap (Dufourmentel type): backCase 2.6Double rhomboid flap: foreheadCase 2.7Bilobed flap: postauricularCase 2.8Rotation flap: scalp (small)Case 2.9Rotation flap: scalp (large)Case 2.10Rotation flap: cheekCase 2.11 Rotation flap: cheekCase 2.12 Rotation flap: foreheadCase 2.13Rotation flap: soleCase 2.14 Rotation flap: dorsum of handCase 2.15 Simple advancement flap: forearm Case 2.16 Crescentic advancement flap: alar baseCase 2.17 Advancement flap: cheekBase 2.18 Two stage flap: cross finger flapChapter 3Island flapsCase 3.1Simple island flap: cheekCase 3.2Simple island flap: cheek-nose junctionCase 3.3 Larger island flap: cheekCase 3.4Island flap: foreheadCase 3.5Island flap: thumbCase 3.6Lateral pedicle island flap: legCase 3.7Fasciocutaneous island flap (Behan keystone flap): legCase 3.8Island flap: forehead to lower eyelidChapter 4 Nose reconstruction Case 4.1Simple transposition flap: noseCase 4.2Transposition flap: alaCase 4.3Glabellar flap: upper noseCase 4.4Shorter Rieger flap: dorsal noseCase 4.5Bilobed flap: upper noseCase 4.6Bilobed flap: nasal tipCase 4.7V to Y island flap: cheek to nasal dorsumCase 4.8Nasolabial V to Y flapCase 4.9 V to Y horn flap: nasal dorsumCase 4.10Horn flap: nasal tipCase 4.11V to Y island flap: ala nasiCase 4.12Lateral pedicle V to Y island flap: alar rimCase 4.13Full thickness skin graft: nose tipCase 4.14Full thickness skin graft: columellaCase 4.15Two stage flap: forehead to noseChapter 5 Lip reconstruction Case 5.1Wedge excision lipCase 5.1Wedge excision: lipCase 5.2Wedge advancement: lower lipCase 5.3Single limb advancement flap: upper lipCase 5.4Double limb advancement flap: upper lipCase 5.5Bilateral advancement flaps: upper lipCase 5.6Small island flap: upper lipCase 5.7Large V to Y island flap: upper lipCase 5.8V to Y island flap reconstruction: lower lipCase 5.9Abbe (lip switch) lipCase 5.10NasolabialChapter 6Aims of eyelid reconstructionCase 6.1Transposition flap: inner canthusCase 6.2Wedge advancement: lower lidCase 6.3Rotation flap repair: lower eyelidCase 6.4V to Y island flap reconstruction: lower eyelidCase 6.5Whole lower eyelid reconstruction: bipedicled Tripier flapCase 6.6Whole lower eyelid reconstruction: V to Y islandCase 6.7Switch flap: upper eyelidChapter 7Ear reconstructionCase 7.1Postauricular transposition flap: helical rimCase 7.2Postauricular transposition flap: helical rootCase 7.3Pre-auricular transposition flap: helical rimCase 7.4Pre-auricular transposition flap: helical rootCase 7.5Advancement flap: helical rimCase 7.6Postauricular pull through flapCase 7.7Pull through flap (foldover type): earCase 7.8Pull through flap (revolving door type): earPart C Common problems and solutionsChapter 88.0Introduction8.1Incomplete excision8.2Haematoma and bleeding8.3Flap ischaemia8.4Flap inadequate for defect8.5Hypertrophic scar and keloid8.6Excess flap thickness and pincushioning8.7Bridging scar – Zplasty8.8EctropionSuggested readingIndex