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The flap is incised and elevated over the periosteum from distal to proximal. [1] The flap consists of skin, subcutaneous tissue, fat and frontalis muscle and is not thinned. When reaching the brow, all of the skin borders are incised and the flap is carefully released. [1] The full-thickness flap is then sutured into the defect without tension.
During this process, facial muscles might be tightened, while facial fat might be removed or redistributed. Sometimes, a jaw lift is performed in the same surgery by making an incision under the chin and tightening the skin of the jaw and neck. Immediately after the surgery, a drainage tube is used to remove excess fluid from the wound. [23] [24]
Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment - CCPDMA) using frozen section histology. [1] CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
Flap surgery is a technique essential to plastic and reconstructive surgery.A flap is defined as tissue that can be moved to another site and has its own blood supply.This is in comparison to a skin graft which does not have its own blood supply and relies on vascularization from the recipient site. [2]
The transposition of two triangular flaps. The incisions are designed to create a Z shape with the central limb aligned with the part of the scar that needs lengthening or re-aligning. The traditional 60° angle Z-plasty will give a theoretical lengthening of the central limb of 75%. [1] Single or multiple z-plasties can be used.
As the CCPDMA surgery is frequently performed using frozen section pathology, immediate reporting of positive surgical margin is made, and the tumor can be completely removed in the same day. Traditional pathology processing is called "bread loafing", and only allows for the partial examination of the surgical margin.
Anterolateral thigh flap (ALT flap) Musculocutaneous: Free flap/Interpolation: Abdominal wall [1] / Open tibial fractures / Esophageal reconstruction [2] Becker flap: Fasciocutaneous: Interpolation: Hand reconstruction Deep inferior epigastric perforator (DIEP) flap [3] Cutaneous: Free flap: Free flap breast reconstruction: Dufourmental flap ...