RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00029352.xml
PDF herunterladen
CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2023; 08(02): e97-e113
DOI: 10.1055/s-0043-1777098
DOI: 10.1055/s-0043-1777098
Original Article
“P6LAND”: An Educational Tool for Free Flaps
Funding None.
Abstract
Background Microsurgical education requires both technical skill and didactic knowledge. Learners are frequently asked to describe free flaps and their knowledge tested in clinical work and during exams.
Methods We have created an educational tool that will aid learners in remembering important information related to flaps.
Results “P6LAND” which divides and organizes information into three parts: Preoperative considerations, Pedicle, Position, LANDmarks, Plane of dissection, Protection and Postoperative considerations.
Conclusion The aim of this paper is to further describe this educational tool and to provide a compendium for the most common fasciocutaneous, muscle, perforator, and bone flaps based on the literature. This tool was also prevalidated among a group of learners.
Publikationsverlauf
Eingereicht: 19. November 2022
Angenommen: 31. Juli 2023
Artikel online veröffentlicht:
28. November 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Singh M, Ziolkowski N, Ramachandran S, Myers SR, Ghanem AM. Development of a five-day basic microsurgery simulation training course: a cost analysis. Arch Plast Surg 2014; 41 (03) 213-217
- 2 Loh CYY, Wang AYL, Tiong VTY. et al. Animal models in plastic and reconstructive surgery simulation-a review. J Surg Res 2018; 221: 232-245
- 3 Pafitanis G, Ghanem AM, Myers S. Experimental pork belly : a simulation training model for intramuscular perforator dissection. Plast Reconstr Surg Glob Open 2018; 6 (01) 1-6
- 4 Pafitanis G, Cooper L, Hadjiandreou M, Ghanem A, Myers S. Microvascular anastomotic coupler application learning curve: a curriculum supporting further deliberate practice in ex-vivo simulation models. J Plast Reconstr Aesthet Surg 2019; 72 (02) 203-210
- 5 Pafitanis G, Hadjiandreou M, Miller R. et al. The use of mobile computing devices in microsurgery. Arch Plast Surg 2019; 46 (02) 102-107
- 6 Buntic R, Buntic R. Atlas of Microsurgery Techniques and Principles. Accessed September 5, 2021 at: https://www.microsurgeon.org/
- 7 Joyce CW, Carroll SM. Microsurgery: the top 50 classic papers in plastic surgery: a citation analysis. Arch Plast Surg 2014; 41 (02) 153-157
- 8 Shokrollahi K, Whitaker IS, Nahai F. Flaps. 1st ed.. New York, NY: Thieme Medical Publishers, Inc.; 2017
- 9 Zenn M, Jones G. Reconstructive Surgery: Anatomy, Technique, and Clinical Applications. St. Louis, Missouri: Quality Medical Publishing; 2012
- 10 Horen SR, Jahromi AH, Konofaos P. Temporoparietal fascial free flap: a systematic review. 2021; 87 (06) e189-e200
- 11 Collar RM, Zopf D, Brown D, Fung K, Kim J. The versatility of the temporoparietal fascia flap in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2012; 65 (02) 141-148
- 12 Tang AL, Bearelly S, Mannion K. The expanding role of scapular free-flaps. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (05) 411-415
- 13 Ferrari S, Ferri A, Bianchi B. Scapular tip free flap in head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2015; 23 (02) 115-120
- 14 Powell DK, Nwoke F, Urken ML. et al. Scapular free flap harvest site: recognising the spectrum of radiographic post-operative appearance. Br J Radiol 2013; 86 (1023): 20120574
- 15 Cobb ARM, Koudstaal MJ, Bulstrode NW, Lloyd TW, Dunaway DJ. Free groin flap in hemifacial volume reconstruction. Br J Oral Maxillofac Surg 2013; 51 (04) 301-306
- 16 Amouzou KS, Berny N, El Harti A, Diouri M, Chlihi A, Ezzoubi M. The pedicled groin flap in resurfacing hand burn scar release and other injuries: a five-case series report and review of the literature. Ann Burns Fire Disasters 2017; 30 (01) 57-61
- 17 Al Bayati MJ, Samaha MJ, Samaha G, Habal MB, Thaller SR, Panthaki ZJ. The groin flap revisited: remembering the contributions of Dr Ian Jackson to plastic surgery. J Craniofac Surg 2021; 32 (3, Suppl 3): 1207-1209
- 18 Al-Qattan MM, Al-Qattan AM. Defining the indications of pedicled groin and abdominal flaps in hand reconstruction in the current microsurgery era. J Hand Surg Am 2016; 41 (09) 917-927
- 19 Hwang K. The origins of deltopectoral flaps and the pectoralis major myocutaneous flap. J Craniofac Surg 2016; 27 (07) 1845-1848
- 20 Chan RCL, Chan JYW. Deltopectoral flap in the era of microsurgery. Surg Res Pract 2014; 420892
- 21 Andrews BT, McCulloch TM, Funk GF, Graham SM, Hoffman HT. Deltopectoral flap revisited in the microvascular era: a single-institution 10-year experience. Ann Otol Rhinol Laryngol 2006; 115 (01) 35-40
- 22 Mikami T, Kagimoto S, Yabuki Y. et al. Deltopectoral flap revisited for reconstruction surgery in patients with advanced thyroid cancer: a case report. BMC Surg 2017; 17 (01) 101
- 23 Bakamjian VY. A two-stage method for pharyngoesophageal reconstruction with a primary pectoral skin flap. Plast Reconstr Surg 1965; 36: 173-184
- 24 Wirtz NE, Khariwala SS. Update on the supraclavicular flap. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (05) 439-444
- 25 Trautman J, Gore S, Potter M. et al. Supraclavicular flap repair in the free flap era. ANZ J Surg 2018; 88 (06) 540-546
- 26 Hamidian Jahormi A, Horen SR, Miller EJ, Konofaos P. A comprehensive review on the supraclavicular flap for head and neck reconstruction. Ann Plast Surg 2022; 88 (06) e20-e32
- 27 Ullah S, Asif M, Ubaid M, Khalid A, Khan M, Rahman MF. Lateral arm flap: its usage as pedicle and free flap. Cureus 2020; 12 (12) e12136
- 28 Kokkalis ZT, Papanikos E, Mazis GA, Panagopoulos A, Konofaos P. Lateral arm flap: indications and techniques. Eur J Orthop Surg Traumatol 2019; 29 (02) 279-284
- 29 Amin JD, Amin N, Hatten KM. The lateral arm free flap for head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2020; 28 (05) 365-369
- 30 Tan O, Aydin OE, Cinal H. et al. Latissimus dorsi flap harvest with a short incision. Microsurgery 2013; 33 (03) 203-206
- 31 Abdelmofeed AM, Fadey MA, Seif O, Abdelhalim MH, Younes MT. Usefulness of nerve-sparing pedicled segmental latissimus dorsi muscle flap combined with lateral thoracic skin flap for partial volume reconstruction in laterally located breast cancer. Eur J Plast Surg 2023; 46: 541-550
- 32 Lin CH, Wei FC, Levin LS, Chen MC. Donor-site morbidity comparison between endoscopically assisted and traditional harvest of free latissimus dorsi muscle flap. Plast Reconstr Surg 1999; 104 (04) 1070-1077 , quiz 1078
- 33 Chung J-H, You H-J, Kim H-S, Lee BI, Park SH, Yoon ES. A novel technique for robot assisted latissimus dorsi flap harvest. J Plast Reconstr Aesthet Surg 2015; 68 (07) 966-972
- 34 Djordjevic ML, Bumbasirevic MZ, Vukovic PM, Sansalone S, Perovic SV. Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children. J Pediatr Urol 2006; 2 (04) 333-339
- 35 Chiang I-H, Wang C-H, Tzeng Y-S. et al. Breast reconstruction using pedicled latissimus dorsi myocutaneous flaps in Asian patients with small breasts. Ann Plast Surg 2017; 78 (3, Suppl 2): S95-S101
- 36 Patel K, Lyu DJ, Kademani D. Pectoralis major myocutaneous flap. Oral Maxillofac Surg Clin North Am 2014; 26 (03) 421-426
- 37 Grinsell D, Lonie S, Wilson KC, Choong PFM. The innervated rectus abdominis flap for quadriceps reconstruction. J Plast Reconstr Aesthet Surg 2019; 72 (06) 941-945
- 38 Radwan RW, Tang AM, Harries RL, Davies EG, Drew P, Evans MD. Vertical rectus abdominis flap (VRAM) for perineal reconstruction following pelvic surgery: a systematic review. J Plast Reconstr Aesthet Surg 2021; 74 (03) 523-529
- 39 Van Vliet A, Girardot A, Bouchez J. et al. How big is too big? The effect of defect size on postoperative complications of vertical rectus abdominis flap reconstruction. Ann Plast Surg 2021; 86 (6S, Suppl 5): S571-S574
- 40 Buchel EW, Finical S, Johnson C. Pelvic reconstruction using vertical rectus abdominis. Ann Plast Surg 2003; 52 (01) 22-26
- 41 Sinnott CJ, Stavrides S, Boutros C, Kuruvilla A, Glickman LT. Dual-plane gluteal myocutaneous flap for reconstruction of ischial tuberosity pressure wounds. Ann Plast Surg 2020; 85 (S1, Suppl 1): S23-S27
- 42 Han HH, Choi EJ, Moon SH, Lee YJ, Oh DY. Combined V-Y fasciocutaneous advancement and gluteus maximus muscle rotational flaps for treating sacral sores. BioMed Res Int 2016; 8714713
- 43 Doi K, Hattori Y, Soo-Heong T, Hiura Y, Kawakami F. Endoscopic harvesting of the gracilis muscle for reinnervated free-muscle transfer. Plast Reconstr Surg 1997; 100 (07) 1817-1823
- 44 Zukowski M, Lord J, Ash K, Shouse B, Getz S, Robb G. The gracilis free flap revisited: a review of 25 cases of transfer to traumatic extremity wounds. Ann Plast Surg 1998; 40 (02) 141-144
- 45 Dornseifer U, Kleeberger C, Kargl L. et al. Perfusion controlled mobilization after lower extremity free flaps-pushing the limits of time and intensity. J Reconstr Microsurg 2017; 33 (03) 179-185
- 46 Walton Z, Armstrong M, Traven S, Leddy L. Pedicled rotational medial and lateral gastrocnemius flaps: surgical technique. J Am Acad Orthop Surg 2017; 25 (11) 744-751
- 47 Houdek MT, Wagner ER, Wyles CC. et al. Long-term outcomes of pedicled gastrocnemius flaps in total knee arthroplasty. J Bone Joint Surg Am 2018; 100 (10) 850-856
- 48 Gkiatas I, Korompilia M, Kostas-Agnantis I, Tsirigkakis SE, Stavraki M, Korompilias A. Gastrocnemius pedicled muscle flap for knee and upper tibia soft tissue reconstruction. A useful tool for the orthopaedic surgeon. Injury 2021; 52 (12) 3679-3684
- 49 Padberg FT, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg 2004; 39 (01) 79-87
- 50 Reece EM, Raghuram AC, Bartlett EL. et al. Vascularized iliac bone graft for complex closure during spinal deformity surgery. Plast Reconstr Surg Glob Open 2019; 7 (07) e2345
- 51 Zhao D, Wang B, Liu B. Vascularized iliac bone flap transfer for early and middle stages of osteonecrosis of the femoral head. JBJS Essential Surg Tech 2019; 9 (01) e5
- 52 Al Deek NF, Kao HK, Wei FC. The fibula osteoseptocutaneous flap: concise review, goal-oriented surgical technique, and tips and tricks. Plast Reconstr Surg 2018; 142 (06) 913e-923e
- 53 Awad ME, Altman A, Elrefai R, Shipman P, Looney S, Elsalanty M. The use of vascularized fibula flap in mandibular reconstruction; a comprehensive systematic review and meta-analysis of the observational studies. J Craniomaxillofac Surg 2019; 47 (04) 629-641
- 54 Guo L, Ferraro NF, Padwa BL, Kaban LB, Upton J. Vascularized fibular graft for pediatric mandibular reconstruction. Plast Reconstr Surg 2008; 121 (06) 2095-2105
- 55 Sarik JR, Bank J, Wu LC, Serletti JM. Superficial inferior epigastric artery: learning curve versus reality. Plast Reconstr Surg 2016; 137 (01) 1e-6e
- 56 Grünherz L, Wolter A, Andree C. et al. Autologous breast reconstruction with SIEA flaps: an alternative in selected cases. Aesthetic Plast Surg 2020; 44 (02) 299-306
- 57 Chevray PM. Update on breast reconstruction using free TRAM, DIEP, and SIEA flaps. Semin Plast Surg 2004; 18 (02) 97-104
- 58 Mangialardi ML, Baldelli I, Salgarello M, Raposio E. Thoracodorsal artery perforator flap in partial breast reconstruction: a systematic review. Plast Reconstr Surg Glob Open 2020; 8 (10) e3104
- 59 Beugels J, Cornelissen AJM, van Kuijk SMJ. et al. Sensory recovery of the breast following innervated and noninnervated DIEP flap breast reconstruction. Plast Reconstr Surg 2019; 144 (02) 178e-188e
- 60 Nahabedian MY, Tsangaris T, Momen B. Breast reconstruction with the DIEP flap or the muscle-sparing (MS-2) free TRAM flap: is there a difference?. Plast Reconstr Surg 2005; 115 (02) 436-444 , discussion 445–446
- 61 Tan BKH, Newman MI, Swartz KA, Samson MC. Subfascial perforator dissection for DIEP flap harvest. Plast Reconstr Surg 2009; 124 (03) 1001-1002
- 62 Tregaskiss A, Perez-Temprano A, Morris RJ. The subfascial perforator dissection for DIEP flap harvest. Plast Reconstr Surg 2008; 122 (05) 145e-146e
- 63 Feingold RS. Improving surgeon confidence in the DIEP flap: a strategy for reducing operative time with minimally invasive donor site. Ann Plast Surg 2009; 62 (05) 533-537
- 64 Gravvanis A, Niranjan NS. Retrograde dissection of the vascular pedicle of deep inferior epigastric artery perforator (DIEAP) flap. Ann Plast Surg 2008; 60 (04) 395-397
- 65 Xue EY, Cen N, Reece E, Chu CK, Winocour S. A standardized approach to deep inferior epigastric perforator flap marking. Plast Reconstr Surg Glob Open 2019; 7 (10) e2479
- 66 Médard de Chardon V, Balaguer T, Chignon-Sicard B. et al. The radial forearm free flap: a review of microsurgical options. J Plast Reconstr Aesthet Surg 2009; 62 (01) 5-10
- 67 Avery CME. Review of the radial free flap: is it still evolving, or is it facing extinction? Part one: soft-tissue radial flap. Br J Oral Maxillofac Surg 2010; 48 (04) 245-252
- 68 Hunter C, Moody L, Luan A, Nazerali R, Lee GK. Superior gluteal artery perforator flap: the beauty of the buttock. Ann Plast Surg 2016; 76 (May, Suppl 3): S191-S195
- 69 Mirzabeigi MN, Au A, Jandali S, Natoli N, Sbitany H, Serletti JM. Trials and tribulations with the inferior gluteal artery perforator flap in autologous breast reconstruction. Plast Reconstr Surg Glob Open 2011; 128 (06) 614-624
- 70 Tsuihiji K, Daniel BW, Kageyama T. et al. Free tensor fascia lata true-perforator flap transfer for reconstruction of the calcaneal soft tissue defect complicated with osteomyelitis in a patient with alcohol-induced Charcot foot: a case report and literature review. Microsurgery 2021; 41 (05) 473-479
- 71 Singh R, Wadhwani J, Rohilla RK, Kaur K. Proximal femoral resection and tensor fascia lata flap for recalcitrant trochanteric pressure ulcers. Spinal Cord Ser Cases 2019; 5: 15
- 72 Zeidler KR, Son JH, Carey JN, Watt AJ, Ho OH, Lee GK. Transverse tensor fascia lata myocutaneous flap for microvascular breast reconstruction: case report and review of the literature. Ann Plast Surg 2013; 70 (04) 438-441
- 73 Graboyes EM, Hornig JD. Evolution of the anterolateral thigh free flap. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (05) 416-421
- 74 Wong C-H, Wei F-C. Anterolateral thigh flap. Head Neck 2010; 32 (04) 529-540
- 75 Schoeller T, Huemer GM, Shafighi M, Gurunluoglu R, Wechselberger G, Piza-Katzer H. Free anteromedial thigh flap: clinical application and review of literature. Microsurgery 2003; 24 (01) 43-48
- 76 Hoshal SG, Bewley AF. The anteromedial thigh free flap: a primary reconstructive option or second best?. Curr Opin Otolaryngol Head Neck Surg 2018; 26 (05) 312-318
- 77 Zhou X, Wang J, Qiang L, Rui Y, Xue M. Outcomes of using a modified anteromedial thigh perforator flap for repairing the anterolateral thigh free flap donor site: a retrospective clinical review. Medicine (Baltimore) 2018; 97 (16) e0491
- 78 Gong ZJ, Zhang S, Ren ZH, Zhu ZF, Liu JB, Wu HJ. Application of anteromedial thigh flap for the reconstruction of oral and maxillofacial defects. J Oral Maxillofac Surg 2014; 72 (06) 1212-1225