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November 1987

The Importance of the Basic Classifications of Skin Flaps

Author Affiliations

2440 M St NW Washington, DC 20037

Arch Dermatol. 1987;123(11):1431. doi:10.1001/archderm.1987.01660350025002

To the Editor.—  I read with interest the article entitled "Subcutaneous Island Pedicle Flaps" by Tomich et al1 in the April issue of the Archives. I am pleased to see the recent increase in the number of articles dealing with dermatologic surgery in the Archives. It is disturbing, however, to note the propagation in the dermatologic literature of a misconception that began with a very similar article by Dzubow.2 Specifically, one method of classification of skin flaps is based on their blood supply. Under this classification, two separate categories of flaps exist. The first, cutaneous flaps, receive their blood supply from segmental, anastomotic, or axial arteries lying deep to the underlying musculature and sending perforating arteries to the interconnecting dermal subdermal plexus of the skin. The second type, arterial flaps, receive their blood supply through a direct cutaneous artery. The second group may be subclassified as peninsular, or

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