Reconstructive Flap Surgery[edit | edit source]
Flap Classifications[edit | edit source]
Flaps may be defined in multiple ways, but, commonly, local flaps are defined by the type of vascularity supplying the flap tissue.
- Random Pattern: This flap type relies on perfusion solely through inflow from the subdermal plexus (see skin vascular anatomy figure below). As a result, it does not have a predefined vessel or contributing artery that can be isolated or defined. For that reason, it is defined as a “random” pattern flap. These flaps must remain connected to the adjacent skin on at least one side and with as broad of a base as possible to maximize perfusion through the subdermal plexus.
- Axial: In contrast to random pattern flaps which rely on subdermal plexus circulation through the attached base, axial pattern flaps have a defined or direct cutaneous artery and vein which can be identified and isolated if needed to increase flap mobilization. Axial flaps, therefore, have more opportunity for complex shapes or designs given the more predictable form of circulation. However, direct vessels to the desired flap area are not always available or needed, which is when random pattern flaps are used to great effect.
