Abstract
Today a great variety of techniques are available to reconstruct any limb defect. Because of this, one should select an appropriate method and not use a particular technique for all defects. We found the adipofascial flap to be suitable and advantageous for many defects. This paper describes the anatomical basis, planning, technique, and variations of the adipofascial flap. The majority of these flaps are defect-based hinge flaps incorporating perforators in the base, and hence they are perforator-perfused flaps. A skeletonized perforator flap has increased malleability and achieves more distal reach. These can also be used as a free flap. An adipofascial flap has several advantages, e.g., minimal donor site morbidity, greater mobility, and more refined reconstruction, and it provides a good gliding surface for the tendons and avoids hair bearing skin transfer. A series of 32 cases performed over 5 years is presented.
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Bhattacharya V, Deshpande SB, Watts RK, Raveendra RG, Singh SK, Sunish G (2005) Measurement of perfusion pressure of perforators and its correlation with their internal diameter. Br J Plast Surg 58:759
Bhattacharya V, Goyal S (2005) A dye study in fresh cadavers to outline retrograde flaps of the lower limbs and to examine clinical implication. Eur J Plast Surg 28:458
Bhattacharya V, Watts RK, Reddy GR (2005) Live demonstration of microcirculation in deep fascia and its implication. Plast Reconstr Surg 115:458
El-Khatib H, Zeidan M (1997) Island adipofascial flap based on distal perforators of the radial artery: an anatomic and clinical investigation. Plast Reconstr Surg 100:1762
Hsieh CH, Yang CC, Kuo YR, Tsai HH, Jeng SF (2003) Free anterolateral thigh adipofascial perforator flap. Plast Reconstr Surg 112:976
Lai CS, Lin SD, Yang CC, Chou CK (1991) Adipofascial turn over flap for reconstruction of the dorsum of the foot. Br J Plast Surg 44:170
Lai CS, Lin SD, Yang CC, Chou CK (1993) The adipofascial turn over flap for elbow coverage. Ann Plast Surg 28:190
Lai CS, Lin SD, Yang CC, Chou CK (1991) The adipofascial turn over flap for complicated dorsal skin defects of hand and fingers. Br J Plast Surg 44:165
Lee S, Estela CM, Burd A (2001) The lateral distally based adipofascial flap of the lower limb. Br J Plast Surg 54:303
Lin SD, Lai CS, Chiu YT, Lin TM, Chou CK (1996) Adipofascial flap of the lower leg based on saphenous artery. Br J Plast Surg 49:390
Lin SD, Lai CS, Chiu YT, Lin TM (1996) The lateral calcaneal artery adipofascial flap. Br J Plast Surg 49:52
Lin SD, Lai CS, Chou CK, Tsai CW (1992) The distally based posterior tibial arterial adipofascial flap. Br J Plast Surg 45:284
Lin SD, Lai CS, Tsai CC, Chou CK, Tsai CW (1995) Clinical application of the distally based medial adipofascial flap for soft tissue defects on the lower half of the leg. J Trauma 38:623
Lin SD, Wang HJ, Chou CK, Kung FP, Lai CS (1998) Endoscopically assisted adipofascial flap harvest for soft tissue defects of the lower leg. Br J Plast Surg 51:38
Ponten B (1981) The fasciocutaneous flap: its use in soft tissue defects of the lower leg. Br J Plast Surg 34:215
Sarhadi NS, Quaba AA (1993) Experience with the adipofascial turn over flap. Br J Plast Surg 46:307
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Bhattacharya, V., Goyal, S. & Bashir, S.A. Reconstructive implications of adipofascial flaps in limb defects. Eur J Plast Surg 30, 169–175 (2007). https://doi.org/10.1007/s00238-007-0166-2
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DOI: https://doi.org/10.1007/s00238-007-0166-2