A commonly used flap classification method is dividing them into the 4 categories below:
Another classification system for flaps also breaks them down into 4 major categories:
1. Burow’s triangle displacement flaps: (Tissue advancement, requires extensive undermining, depends on skin laxity and tissue elasticity)
2. Defect reconfiguration flap: (Island pedicle flaps, tissue advancement depends on pedicle movement, blood supply from pedicle)
3. Tissue reorientation flaps: (Reorientation of adjacent skin in area of laxity)
4. Tissue importation flaps: (Covering large wounds, cover avascular defects, two stages)
However, in clinical practice where surgery is being planned on a large tumor or where there is an anticipated large and complex reconstruction anticipated in patients on multiple anticoagulants, many surgeons will choose to discuss discontinuing one or more of the anticoagulants in consultation with the patient’s cardiologist prior to surgery. Unless there are extenuating circumstances, consultation with cardiology is not needed, as anticoagulants are generally continued in dermatologic surgery.
Risks of bleeding complications are highest in the first 48 hours. When encountering a hematoma, the first assessment to be made is whether the bleeding has caused a stable hematoma or an ongoing expanding hematoma.