The assurance of the circulation of pedunculated skin flaps1 is of vast importance in plastic surgery. Often it is possible to form a single pedicled flap and to shift it into its new bed immediately. When this is done one must remember that roughly the length of the flap should not be more than two and a half times the width of the pedicle, unless the flap contains an artery, such as the anterior temporal, in which case it may be as long as the artery will nourish and the pedicle may be very narrow, consisting in fact, if necessary, of only the artery and accompanying veins. Frequently much longer flaps are needed than those that can be conveniently made two and a half times the length of the pedicle, and these must often be obtained from an area in which no definite artery is available.
Flaps that are
WILLIAM GERMAN, EDWARD M. FINESILVER, JOHN STAIGE DAVIS. ESTABLISHMENT OF CIRCULATION IN TUBED SKIN FLAPSAN EXPERIMENTAL STUDY. Arch Surg. 1933;26(1):27–40. doi:10.1001/archsurg.1933.01170010030003