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Notable Notes
June 2018

Island Pedicle Flap—Its Place in History

Author Affiliations
  • 1Baylor College of Medicine, Houston, Texas
JAMA Dermatol. 2018;154(6):683. doi:10.1001/jamadermatol.2018.0450

The island pedicle flap, also known as the V-to-Y advancement flap, is highly regarded by reconstructive surgeons owing to its robust blood supply, color and textural match, minimization of tension, and inherent adaptability. Although used by dermatologists in contemporary practice, particularly for defects on the nose and central face, the V-to-Y flap’s origins and historical contextualization are not as well known.

Flap surgery was first described around 600 to 700 bc by Indian surgeon Susrata in his text Samahita and was mostly performed by the brick maker caste in India, who guarded the technique as a family secret. This medical knowledge was later shared with the Greeks and Romans.1,2 After the Arabs occupied Sicily during the 9th to 12th centuries, the original Indian texts, translated to Arabic, were disseminated to all of Europe, historically among the first international trade of technical knowledge.2

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