Reconstructive implications of adipofascial flaps in limb defects

Today a great variety of techniques are available to reconstruct any limb defect. Because of this, one should select an appropriate method and not use a particular technique for all defects. We found the adipofascial flap to be suitable and advantageous for many defects. This paper describes the anatomical basis, planning, technique, and variations of the adipofascial flap. The majority of these flaps are defect-based hinge flaps incorporating perforators in the base, and hence they are perforator-perfused flaps. A skeletonized perforator flap has increased malleability and achieves more distal reach. These can also be used as a free flap. An adipofascial flap has several advantages, e.g., minimal donor site morbidity, greater mobility, and more refined reconstruction, and it provides a good gliding surface for the tendons and avoids hair bearing skin transfer. A series of 32 cases performed over 5 years is presented.