Axial Flaps

An axial pattern flap incorporates an anatomically named vascular pedicle. Due to the direct cutaneous blood supply, a large skin area can be transferred acutely rather than in a delayed fashion that has previously been the gold standard. Historically, random pattern flaps were harvested in a delayed manner to foster better circulation to the flap. There are several advantages when using an axial pattern flap, which includes no need for delay procedures, full-thickness, durable skin, and excellent cosmetic results. Furthermore, it has been shown that the area of survival in axial pattern flaps is significantly better versus flaps which do not incorporate a direct cutaneous blood supply. Studies have shown the difference in 95% survival for axial pattern flaps versus 53% survival in flaps without a direct cutaneous supply. Some examples of axial pattern flaps include:

1. Nasolabial flap off of the angular vessels

2. Paramedian forehead flap off of the supratrochlear vessels

3. Facial artery musculomucosal flap

4. Melolabial flap