Cutaneous Muscle Flap: A Case Report
05 October 2009 (online)
Advances in flap surgery are one of the most important and exciting topics of reconstructive surgery. An increased variety of flaps and the development of varied transfer methods have caused changes in reconstructive concepts. Early on, tissue defects were treated with simple reconstructive methods; however, achieving good cosmetic outcomes, good functional results, and minimal donor site deformities are issues considered today.
The development of musculocutaneous flaps in the 1970s provided great advances in reconstructive surgery. The blood supply to musculocutaneous system comes primarily from the main artery supplying the muscle, and it reaches the skin by branching vessels traversing through the muscle. These musculocutaneous perforators alone or together with the direct cutaneous vessels create the microcirculatory system of skin in the subcutaneous tissues.
Although the skin paddle of a musculocutaneous flap is commonly nourished through the musculocutaneous perforators, whether the opposite is true is not known. If the blood supply of the muscle could be adequately maintained by reverse flow from the overlying skin flap through musculocutaneous perforators, the muscle could be transferred with that skin flap as a carrier. In our previous experimental study of cutaneous muscle flaps (CMFs), we showed the preservation of muscle viability when carried under the raised skin flap.  In this report, we applied this concept to a new skin flap in a case of head and neck reconstruction.
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Sukru Yazar, M.D.
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