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What Is a Rotation Flap?

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  • Written By: Cindy Quarters
  • Edited By: Shereen Skola
  • Last Modified Date: 15 August 2014
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A rotation flap is a section of the patient’s own skin and underlying muscle that is typically used as a graft in reconstructive surgery. It is commonly used to cover large wounds caused by such things as accidents or the removal of a tumor. The flap of skin that is used is usually adjacent to the damaged area. The skin is cut in such a way that it is not completely removed from the patient, thus ensuring that it continues to have an adequate blood supply. It is then rotated to cover the wound.

This type of procedure is often used to fill in a depressed area where the patient is lacking both skin and muscle. This can be due to an injury as well as such problems as severe bedsores and skin ulcers. The technique is common during reconstructive surgery for patients who have had cancer surgery on their face and scalp. Using a rotation flap is also helpful for burn victims, in many cases.

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To create a rotation flap, the doctor maps out an area of skin that can be shifted to fill in the defective spot. The skin and the upper layer of muscle directly beneath it is detached. A bridge of skin and muscle is left in place in order to provide circulation while the graft adapts to the new location and grows new blood vessels. Once the flap has healed, the bridge connecting it to its original location can be cut if necessary for the patient’s comfort.

The surgeon will typically make the rotation flap much larger than is needed to cover the wound. Much of this size is needed to allow for the rotation of the section of skin. How much is actually required depends largely on the elasticity of the patient’s skin. It is essential that the flap be big enough to cover the entire wound for the best outcome for the patient. Once the flap has been cut and stitched into place, the surgeon can trim any excess skin to give the area a neat appearance.

One of the most important decisions doctors make surrounding this procedure is determining whether or not the donor site has an adequate blood supply. Some areas of the body are very well suited to this procedure, such as the scalp, face, hands and torso. Other areas, particularly the lower legs, do not have an abundant blood supply and a rotation flap used in these areas is likely to fail.

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