Dewey Jesse, Bermudez Rene
Campbell University
Sampson Regional Medical Center
When performing Mohs micrographic facial surgery, many different closure techniques are available to preserve function and cosmesis. Island pedicle flaps, a form of advancement flap, are unique as these flaps primarily use the vascular supply from the subcutaneous tissue to prevent flap failure. Island pedicle flaps are used when repairing small- to medium-sized defects where minimal spare tissue is available, as on the face. The traditional design of the island pedicle flap is a triangle with a short base and 2 long legs of near equal length; variations exist. The base of the triangle is advanced into the position of the primary defect. This flap design allows for convenient closure of the secondary defect because the 2 longer legs of the triangle are already positioned for a linear closure. The original incisions of the flap are V-shaped, with the resulting suture lines in the shape of a Y, which gives the island pedicle flap another name—the V-Y advancement flap. This advancement flap severs all dermal attachments around the triangular flap while leaving the subcutaneous vascular attachments on the inferior side of the flap intact.
在进行莫氏显微外科面部手术时，可以采用多种不同的闭合技术来保留功能和美观。岛状蒂皮瓣作为推进皮瓣的一种形式，具有独特性，因为这些皮瓣主要利用皮下组织的血管供应来防止皮瓣坏死。当修复面部等几乎没有多余组织的中小面积缺损时，会使用岛状蒂皮瓣。岛状蒂皮瓣的传统设计是一个短底边和两条近乎等长的长腿的三角形；也存在一些变体。三角形的底边推进到原发性缺损的位置。这种皮瓣设计便于闭合继发性缺损，因为三角形的两条较长边已经处于线性闭合的位置。皮瓣的原始切口呈V形，缝合线呈Y形，这也赋予了岛状蒂皮瓣另一个名称——V-Y推进皮瓣。这种推进皮瓣切断了三角形皮瓣周围的所有真皮附着，同时使皮瓣下侧的皮下血管附着保持完整。
