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Why and when to delay TFL flaps

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Summary

Sensory TFL flaps have to be extended to the ischial and perianal region of patients suffering from a low spinal cord lesion if they are to provide optimal sensitivity as well as adequate length. A sensory TFL flap which extends to the perianal area may also help such patient to control his bowel function. In order to mobilize a large sensory TFL flap, 3 to 4 musculocutaneous vessels originating from the vastus lateralis femoris muscle have to be cut within 14 cm above the knee joint. The resulting random pattern skin flap segment of such extended sensory TFL flap is prone to develop inadequate blood supply when transposed to its new bed, especially if the subcutaneous fat layer is thicker than 1,5 to 2 cm. Under such conditions the delay procedure is advisable to preserve the entire length of an enlarged sensory myodermal TFL flap.

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Krupp, S., Milliet, A.C. Why and when to delay TFL flaps. Chir Plastica 7, 23–31 (1982). https://doi.org/10.1007/BF00266801

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Key words

  • Extended sensory TFL flap
  • Random pattern skin segment of TFL flap
  • Delay of extended sensory TFL flap