''Flap Surgery''

x-pumpkin · #1 ● 02-02-2012, 07:43 PM

Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with an intact blood supply. This is similar to but different from a graft, which does not have an intact blood supply and therefore relies on growth of new blood vessels. This is done to fill a defect such as a wound resulting from injury or surgery when the remaining tissue is unable to support a graft, or to rebuild more complex anatomic structures such as breast or jaw

Exposure to carcinogens can cause cancers of the lower lip. If these cancers are not addressed in a timely fashion, the cancer can replace the substance of the lower lip almost entirely. Surgical removal of these tumors requires total lower lip excision and bilateral neck dissection.
The skin, fat, and fascia on the medial aspect of the forearm is thin and pliable to conform to defects of the lower lip and oral lining. The arterial supply of the forearm is derived from the radial artery and the venous drainage is served by the cephalic vein. When incorporated properly, the palmaris longus can be used as a sling to provide oral competence.

Appropriate inset of the flap requires microsurgical anastamosis of the flap vessels to the vesesls of the neck. The palmaris longus tendon is sutured to the modiolus and the malar eminence. The radial artery is anastamosed to the facial artery and the cephalic vein is anastamosed to the external jugular vein.