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Semin Plast Surg 2003; 17(4): 351-362
DOI: 10.1055/s-2004-817707
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Flap Prefabrication and Prelamination in Head and Neck Reconstruction

Julian J. Pribaz1,2 , Lifei Guo1
  • 1Harvard Plastic Surgery Program, Brigham and Women's Hospital, Boston, MA
  • 2Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA
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Publication History

Publication Date:
13 April 2004 (online)

Also available atMedOne
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ABSTRACT

Flap prefabrication and prelamination are relatively new concepts in reconstructive surgery. Although closely related, they are two uniquely different techniques. They are primarily employed in reconstructing complex defects that cannot be repaired with simpler and more conventional techniques. For the head and neck, where defects are often complex, donor options few, and aesthetic demands high, the role of prefabricated and prelaminated flaps is becoming increasingly important. Flap prefabrication starts with transposition of a vascular pedicle into a body of donor tissue that otherwise does not possess an axial blood supply. Flap prelamination, on the other hand, starts with addition of tissue layers into an established vascular bed. Both procedures then require a second stage in which a prefabricated or prelaminated flap is transferred to its final location. This article describes our experience with flap prefabrication and prelamination in the head and neck, reviews the literature, and speculates on the future potential of these reconstructive techniques, especially with evolving tissue engineering and embryonic stem cell technologies.

KEYWORDS

Prefabrication - prelamination - head and neck reconstruction - flaps - venous congestion - tissue expansion

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