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Surgical Flaps

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The History of Maxillofacial Surgery

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Abstract

Surgical flaps are key elements in the field of head and neck reconstruction, whose development dates to ca. 1000–800 BCE. Several factors have driven its evolution, most significantly trauma from war, knowledge exchange between surgical specialties, and technological advancements in microsurgery. This chapter begins with an overview of the early history and development of flap techniques. The major flap designs discussed are the deltopectoral and pectoral flaps, the radial forearm, deep circumflex iliac artery, fibula, scapular, anterolateral thigh, supraclavicular, submental island, and the facial artery musculomucosal flap. While this review is not exhaustive, the authors hope to present an overview of the development of the workhorse flaps used in the modern era with some acknowledgment to future direction of this field.

The basis of surgical flaps relies on an understanding of the relationship between vasculature, bone, and soft tissue. This knowledge derives from anatomists and surgeons performing cadaveric dissections. The development of surgical flaps includes contributions from various fields: plastic and reconstructive; otolaryngology – head and neck, oral, and maxillofacial; and orthopedic surgeons, among others. As experience with these techniques matured, older techniques have been modified, and new flaps have been developed. All the while, reconstructive surgeons have remained focused on reducing the donor site morbidity and improving cosmesis and function at the donor and recipient sites.

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Notes

  1. 1.

    Image from Wikimedia commons. Public domain image. Reproduced without alterations. https://commons.wikimedia.org/wiki/File:Indian_method_of_surgical_restoration_of_the_nose._Wellcome_L0017597.jpg Copyrighted work available under Creative Commons Attribution only license CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ http://catalogue.wellcomelibrary.org/record=b1353614

  2. 2.

    This is a media file that Houghton Library believes to be in the public domain of the United States. This applies to a work published before January 1, 1923 or the unpublished work of an author who died more than 70 years ago. Houghton Library and Harvard University claim no rights in this photographic reproduction of the work, and the image is free to download and reproduce for any use, commercial or non-commercial, without any further permission required (Typ 525.97.820, Houghton Library, Harvard University).

  3. 3.

    Marck KW, Palyvoda R, Bamji A et al. The tubed pedicle flap centennial: its concept, origin, rise, and fall. Eur J Plast Surg. 2017;40:473–78. https://doi.org/10.1007/s00238-017-1289-8 Image is of springer collection, need permission

  4. 4.

    Reproduced without modification with permission from Zeiss

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Authors and Affiliations

  1. Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA

    Steven Halepas

  2. Department of Otolaryngology-Head & Neck Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA

    Scott H. Troob

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  1. Steven Halepas
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  2. Scott H. Troob
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Correspondence to Scott H. Troob .

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Editors and Affiliations

  1. Greater Waterbury OMS, Beau Visage Med Spa Partner, Cheshire, CT, USA

    Elie M. Ferneini

  2. Division of Oral & Maxillofacial Surgery, University of Connecticut Health Center, Farmington, CT, USA

    Michael T. Goupil

  3. Columbia University Irving Med Center, NewYork–Presbyterian Hospital, New York, NY, USA

    Steven Halepas

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Halepas, S., Troob, S.H. (2022). Surgical Flaps. In: Ferneini, E.M., Goupil, M.T., Halepas, S. (eds) The History of Maxillofacial Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-89563-1_16

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  • DOI: https://doi.org/10.1007/978-3-030-89563-1_16

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