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October 25, 1985

Plastic Surgery

JAMA. 1985;254(16):2315-2317. doi:10.1001/jama.1985.03360160147041

Recent technology has significantly enhanced the ability of the plastic surgeon to provide reliable wound coverage while preserving or restoring the area's form and function. Musculocutaneous flaps have become standard for safe coverage of wounds with exposure of bone or vital structures.1,2 Through recent anatomic studies of skin circulation, the fasciocutaneous flap has been identified as an alternative method of transferring skin and fascia for wound coverage.3,4 With the addition of microsurgery, both muscle and fasciocutaneous flaps are liberated from a specific arc of rotation. These flaps, attached to their vascular pedicles, are now routinely transplanted to distant sites when local tissue is unavailable.

The muscle flap, with its superior resistance to infection, is utilized to cover chronically infected wounds, complex open tibial fractures, and chronic osteomyelitis after extensive wound débridement.7,8 Muscle transplantation by microsurgery allows coverage of heel weight-bearing areas with durable, well-vascularized tissue.9