Skin Flaps

Abstract

The ability to transfer tissue based on microvascular anastomoses has created a revolution in reconstructive surgery. The microvascular transfer of a skin flap is the prototype for all other free tissue transfers. The publications of Daniel, Taylor, Harii and O’Brien introduced the concept of a ‘free skin flap’ based on microvascular anastomoses. After the initial enthusiasm for cutaneous free tissue transfers, interest shifted to the transfer of muscles with or without their accompanying cutaneous flaps. It became apparent that muscle transfers often had a more vigorous blood supply and a longer, larger vascular pedicle than cutaneous flaps. In many situations, this muscle with attached skin flap, the musculocutaneous flap, is preferred to the cutaneous flap.