eMedicine Specialties > Plastic Surgery > Flaps

Flaps, Muscle and Musculocutaneous Flaps: Multimedia

Author: Perry Hsien-tsung Liu, MD, Fellow in Plastic Surgery, Tulane University Medical Center
Coauthor(s): Ernest S Chiu, MD, Associate Professor of Surgery, Director of Plastic Surgery Research, Division of Plastic and Reconstructive Surgery, Tulane Health Sciences Center; Co-director of Vascular Anomalies Center, Children's Hospital of New Orleans
Contributor Information and Disclosures

Updated: Aug 21, 2008

Multimedia

Type I, vascular patterns of the muscle and muscu...
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Media file 1: Type I, vascular patterns of the muscle and musculocutaneous flaps. One vascular pedicle. Gastrocnemius, tensor fasciae latae, anconeus, vastus intermedius. Image courtesy of Selected Reading in Plastic Surgery.
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Type I, vascular patterns of the muscle and muscu...

Type I, vascular patterns of the muscle and musculocutaneous flaps. One vascular pedicle. Gastrocnemius, tensor fasciae latae, anconeus, vastus intermedius. Image courtesy of Selected Reading in Plastic Surgery.

Type II, vascular patterns of the muscle and musc...
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Media file 2: Type II, vascular patterns of the muscle and musculocutaneous flaps. One dominant vascular pedicle usually entering close to the origin or insertion of the muscle with additional smaller vascular pedicles entering the muscle belly. Abductor digiti minimi, abductor hallucis, biceps femoris, brachioradialis, flexor digitorum brevis, gracilis, peroneus longus, peroneus brevis, platysma, rectus femoris, semitendinosus, soleus, sternocleidomastoid, temporalis, trapezius, vastus lateralis. Image courtesy of Selected Reading in Plastic Surgery.
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Type II, vascular patterns of the muscle and musc...

Type II, vascular patterns of the muscle and musculocutaneous flaps. One dominant vascular pedicle usually entering close to the origin or insertion of the muscle with additional smaller vascular pedicles entering the muscle belly. Abductor digiti minimi, abductor hallucis, biceps femoris, brachioradialis, flexor digitorum brevis, gracilis, peroneus longus, peroneus brevis, platysma, rectus femoris, semitendinosus, soleus, sternocleidomastoid, temporalis, trapezius, vastus lateralis. Image courtesy of Selected Reading in Plastic Surgery.

Type III, vascular patterns of the muscle and mus...
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Media file 3: Type III, vascular patterns of the muscle and musculocutaneous flaps. Two vascular pedicles, each arising from a separate regional artery (except orbicularis oris). Gluteus maximus, rectus abdominis, serratus anterior, semimembranosus, orbicularis oris. Image courtesy of Selected Reading in Plastic Surgery.
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Type III, vascular patterns of the muscle and mus...

Type III, vascular patterns of the muscle and musculocutaneous flaps. Two vascular pedicles, each arising from a separate regional artery (except orbicularis oris). Gluteus maximus, rectus abdominis, serratus anterior, semimembranosus, orbicularis oris. Image courtesy of Selected Reading in Plastic Surgery.

Type IV, vascular patterns of the muscle and musc...
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Media file 4: Type IV, vascular patterns of the muscle and musculocutaneous flaps. Multiple pedicles of similar size. Flexor digitorum longus, extensor hallucis longus, vastus medialis, external oblique, extensor digitorum longus, flexor hallucis longus, sartorius, tibialis anterior. Image courtesy of Selected Reading in Plastic Surgery.
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Type IV, vascular patterns of the muscle and musc...

Type IV, vascular patterns of the muscle and musculocutaneous flaps. Multiple pedicles of similar size. Flexor digitorum longus, extensor hallucis longus, vastus medialis, external oblique, extensor digitorum longus, flexor hallucis longus, sartorius, tibialis anterior. Image courtesy of Selected Reading in Plastic Surgery.

Type V, vascular patterns of the muscle and muscu...
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Media file 5: Type V, vascular patterns of the muscle and musculocutaneous flaps. One dominant vascular pedicle and several smaller secondary segmental vascular pedicles. Pectoralis major, latissimus dorsi. Image courtesy of Selected Reading in Plastic Surgery.
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Type V, vascular patterns of the muscle and muscu...

Type V, vascular patterns of the muscle and musculocutaneous flaps. One dominant vascular pedicle and several smaller secondary segmental vascular pedicles. Pectoralis major, latissimus dorsi. Image courtesy of Selected Reading in Plastic Surgery.

Flap algorithm.
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Media file 6: Flap algorithm.
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Flap algorithm.

Flap algorithm.

More on Flaps, Muscle and Musculocutaneous Flaps

References
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References

  1. Blondeel PN, Van Landuyt KH, Monstrey SJ, et al. The "Gent" consensus on perforator flap terminology: preliminary definitions. Plast Reconstr Surg. Oct 2003;112(5):1378-83; quiz 1383, 1516; discussion 1384-7. [Medline].

  2. Wei FC, Celik N, Jeng SF. Application of "simplified nomenclature for compound flaps" to the anterolateral thigh flap. Plast Reconstr Surg. Apr 2005;115(4):1051-5; discussion 1056-7. [Medline].

  3. Calderon W, Chang N, Mathes SJ. Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. May 1986;77(5):785-94. [Medline].

  4. Gosain A, Chang N, Mathes S, et al. A study of the relationship between blood flow and bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg. Dec 1990;86(6):1152-62; discussion 1163. [Medline].

  5. Yazar S, Lin CH, Lin YT, et al. Outcome comparison between free muscle and free fasciocutaneous flaps for reconstruction of distal third and ankle traumatic open tibial fractures. Plast Reconstr Surg. Jun 2006;117(7):2468-75; discussion 2476-7. [Medline].

  6. Guerra AB, Gill PS, Trahan CG, et al. Comparison of bacterial inoculation and transcutaneous oxygen tension in the rabbit S1 perforator and latissimus dorsi musculocutaneous flaps. J Reconstr Microsurg. Feb 2005;21(2):137-43. [Medline].

  7. Chou EK, Ulusal B, Ulusal A, et al. Using the descending branch of the lateral femoral circumflex vessel as a source of two independent flaps. Plast Reconstr Surg. May 2006;117(6):2059-63. [Medline].

  8. Chang DW, Wang B, Robb GL, et al. Effect of obesity on flap and donor-site complications in free transverse rectus abdominis myocutaneous flap breast reconstruction. Plast Reconstr Surg. Apr 2000;105(5):1640-8. [Medline].

  9. Barrett B. Patient Care in Plastic Surgery. 2nd ed. Mosby; 1996.

  10. Chase RA. The history of vascularized composite tissue transfer. In: Grabbs Encyclopedia of Flaps. Vol 1. 1998.

  11. Choucair MM, Phillips TJ. What is new in clinical research in wound healing. Dermatol Clin. Jan 1997;15(1):45-58. [Medline].

  12. Giunta R, Geisweid A, Lukas B, et al. [Perforator flap-plasty and applications to hand surgery]. Handchir Mikrochir Plast Chir. Nov 2000;32(6):399-403. [Medline].

  13. Hong JP, Chung YK, Chung SH. The effect of prostaglandin E1 versus ischemia-reperfusion injury of musculocutaneous flaps. Ann Plast Surg. Sep 2001;47(3):316-21. [Medline].

  14. Kayser M. Surgical flaps. Selected Readings in Plastic Surgery. 1999;9(2).

  15. Kayser M, Hodges P. Surgical flaps. Selected Readings in Plastic Surgery. 1995;8:14.

  16. Lin CH, Lin YT, Yeh JT, et al. Free functioning muscle transfer for lower extremity posttraumatic composite structure and functional defect. Plast Reconstr Surg. Jun 2007;119(7):2118-26. [Medline].

  17. McCarthy J. Introduction to plastic surgery. In: Plastic Surgery. Vol 1. 1990.

  18. McGregor I. Fundamental Techniques of Plastic Surgery. 9th ed. Churchill Livingstone; 1995.

  19. Rivas B, Carrillo JF, Escobar G. Reconstructive management of advanced breast cancer. Ann Plast Surg. Sep 2001;47(3):234-9. [Medline].

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Further Reading

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Keywords

nasal reconstruction, facial flaps, cross-leg flap, muscle flap, breast reconstruction, latissimus dorsi muscle flap, breast surgery, muscle flap, musculocutaneous flap, nasal repair, nasal surgery, nose reconstruction, nose flap, facial flap

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Contributor Information and Disclosures

Author

Perry Hsien-tsung Liu, MD, Fellow in Plastic Surgery, Tulane University Medical Center
Perry Hsien-tsung Liu, MD is a member of the following medical societies: American College of Surgeons and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Ernest S Chiu, MD, Associate Professor of Surgery, Director of Plastic Surgery Research, Division of Plastic and Reconstructive Surgery, Tulane Health Sciences Center; Co-director of Vascular Anomalies Center, Children's Hospital of New Orleans
Ernest S Chiu, MD is a member of the following medical societies: American Society of Plastic Surgeons, Association of Academic Chairmen of Plastic Surgery, and Plastic Surgery Research Council
Disclosure: Nothing to disclose.

Medical Editor

Geoffrey L Robb, MD, Chair, Professor, Department of Plastic Surgery, University of Texas MD Anderson Cancer Center
Geoffrey L Robb, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American College of Surgeons, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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