Tube pedicle flaps, jump flaps, and waltzed tube pedicle flaps are now only of historical note. The random abdominal flap and vertical hypogastric flap, the first axial flap described, are in their twilight years. The free flap is the current champion for composite tissue reconstruction, the only exception being the functioning myocutaneous transfers that are available in upper extremity reconstruction. The well planned distant flap still can provide high quality skin and subcutaneous tissue for upper extremity coverage. Utilization of this tool, however, requires an overall appreciation and understanding of flap physiology, the ability to shrewdly analyze the reconstructive needs of a given defect, and the skills and knowledge to commit the patient to what is inevitably a two-stage operation spaced over 3 to 5 weeks.
管状蒂皮瓣、跳跃皮瓣和旋转管状蒂皮瓣如今仅具有历史意义。随意腹部皮瓣和垂直下腹皮瓣（首个被描述的轴型皮瓣）正走向衰落。游离皮瓣是目前复合组织重建的首选，唯一的例外是在上肢重建中可用的功能性肌皮转移。精心设计的远位皮瓣仍可为上肢覆盖提供高质量的皮肤和皮下组织。然而，使用这一手段需要全面了解皮瓣生理学，能够敏锐分析特定缺损的重建需求，以及具备相关技能和知识，以便让患者接受不可避免的分两阶段进行、间隔3至5周的手术。
