Distant flaps

Direct distant flaps
Direct distant flaps are connected to the destination directly.
 * Cross-finger flap – flap from 1 finger to adjacent finger with defect of the fingertip, secondary defect of the donor area is covered by skin flap;
 * cross-leg flap;
 * tubulated flap in the lower abdomen – wrist + hand defect coverage.

Indirect distant flaps
Indirect distant flaps are connected to the destination with the help of temporary host destination (usually on the wrist).
 * Filatov flap – oblique strip of skin with subcutaneous tissue in the hypogastrium, length to width ratio 3:1 → tubulated flap → can be disconnected after 3-4 weeks at either end → after sewing + attaching to the wrist disconnect the remaining stem → transfer to the place of the defect;
 * axial groin flap – used as both direct and indirect, nutrition from a. circumflexa ilium superficialis →ratio can be > 3:1.

Fasciocutaneous flaps

 * Local flaps containing deep fascia on the lower limbs in a length to width ratio of 3:1;
 * supplied by fascial vessels and perforators;
 * safely cover e.g. bare bone or tendons;
 * secondary defect is covered by skin flap.

Defined vascular supply, we rate:

 * closeness to defect;
 * necessity, resp. replaceability of the function (we try to keep a part of the muscle for its function);
 * dominant vascular pedicle;


 * defect in place of collection is usually covered by skin flap;
 * most often we use thoracodorsal flap, gastrocnemius flap and flap of the rectus femoris muscle.

Related articles

 * Flaps
 * Local flaps
 * Free flaps
 * Face reconstruction
 * Nose reconstruction
 * Face soft tissue injuries
 * Upper lip reconstruction
 * Lower lip reconstruction
 * Skin transplants