Bilaterally Pedicled V-Y Advancement Flap
L. PONTES
M. RIBEIRO
EDITORIAL COMMENT
A modification of the V-Y flap that allows greater mobility of the flap.
The bilaterally pedicled V-Y advancement flap, based on two lateral subcutaneous pedicles and subtotally freed from its underlying bed on the superficial muscular aponeurotic system (SMAS), is a versatile, cosmetically elegant flap, with a reliable blood supply.
INDICATIONS
Traditional V-Y advancement flaps for reconstruction of soft tissue have been widely used for decades (1, 2, 3). Several subsequent modifications have been proposed to maximize its
advancement, fundamentally by ameliorating its undermining (4) or by the addition of an extended flap segment (5, 6). The laxity of the underlying subcutaneous tissue and its attachments to the fascia determine the degree of advancement in traditional V-Y flaps. When a thin subcutaneous layer is present, this movement is restricted and results in tension on the flap. The subcutaneous bilateral bridges of the flap we present allow for more extensive advancement and coverage of the defect.
advancement, fundamentally by ameliorating its undermining (4) or by the addition of an extended flap segment (5, 6). The laxity of the underlying subcutaneous tissue and its attachments to the fascia determine the degree of advancement in traditional V-Y flaps. When a thin subcutaneous layer is present, this movement is restricted and results in tension on the flap. The subcutaneous bilateral bridges of the flap we present allow for more extensive advancement and coverage of the defect.
ANATOMY
The advancement principle of this flap is based on the subdermal plexus flow to the skin island via subcutaneous bilateral bridges (7) (Fig. 105.1). It differs from traditional V-Y advancement flaps in that it does not rely on the classic subcutaneous central “vertical” pedicle, so that the flap can be advanced more freely to cover a more extensive defect, based only on its bilateral pedicles.
Related posts:
Cheek Rotation Skin (Mustardé) Flap to The Lower Eyelid
Nasalis Musculocutaneous Sliding Flaps for Nasal Tip Reconstruction
Inferior Turbinate Flap for Closure of Septal Perforations
Postauricular and Retroauricular Scalping Flap (The Paras Flap)
Scapular and Parascapular Flaps
Platysma Musculocutaneous Flap to The Lower Lip
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
