A new understanding of “flow-through” concept in flaps surgery and review of the literature

Abstract

The reconstruction of tissue defects by using flaps is recognized nowadays as the best solution. Large and/or complex posttraumatic or post oncologic resections can often include ischemia of a segment because of vascular defects. Such cases need a simultaneous coverage and revascularization of the segment. One of the methods able to solve both these problems is the flow-through-flap procedure. The procedure consists in using a free flap in which both ends of the vascular pedicle can be anastomosed, offering so the possibility to both cover a defect and revascularize a devascularized segment. In very large defects or in complex defects associated with missing amputated fingers, this concept can also be applied by using such a flow-through flap to revascularize a second flap. Unfortunately, there is not yet a clear nomenclature and classification of these flaps. This paper will try to clarify some aspects of this concept and to better classify the flow-through flaps.

Keywords

• Tissue defects
• Microsurgical flaps
• True flow-through flaps
• Flow through conduit flaps
• Venous flow-through flaps