The role of subcutaneous island pedicle flap in the reconstruction of defects after the removal of skin tumours.

Fájlok
This thesis explores the role of the Subcutaneous Island Pedicle Flap (SIPF) and its modifications in reconstructive surgery following the removal of skin tumours. With the rising global incidence of melanoma and non-melanoma skin cancers, particularly in cosmetically sensitive areas such as the head and neck, the demand for reliable reconstructive options has increased significantly. The SIPF, first described during World War I, has become a versatile and effective technique due to its dependable vascular supply and ability to achieve both functional and aesthetic restoration. The work provides a detailed review of the SIPF, including its historical background, anatomical basis, surgical technique, advantages, and drawbacks. Special emphasis is placed on the various modifications of the SIPF—such as the bilateral, bipedicle, rotating, flipped, unilateral laterally based, crescentic, transpositional, and interpolation flaps—that expand its applicability to complex defects. Case studies observed at the University of Debrecen are included to illustrate the practical use of the flap in clinical settings. Through literature review and clinical examples, the thesis highlights the strengths of the SIPF as a single-stage, aesthetically favourable procedure, while also acknowledging limitations such as the trapdoor phenomenon and pincushioning. Overall, the SIPF and its variants represent an invaluable tool in the reconstructive ladder for restoring form and function after skin tumour excision.(1.06 MB)
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With the rising incidence of skin cancers, surgical excision often leaves defects requiring reconstruction. The Subcutaneous Island Pedicle Flap (SIPF), first described by Esser in 1917, remains an invaluable tool, particularly in the head and neck region. Its robust subcutaneous pedicle ensures reliable vascularity, minimizing complications and preserving both function and aesthetics by using adjacent tissue. Common issues include trapdooring, pincushioning, and bulkiness, but these can be reduced with proper planning or flap modifications. Numerous variants such as BLIPF, BPIF, RIPF, and FIPF were developed to overcome specific limitations. While evidence supports its use mainly in the head and neck, SIPF has potential in other regions with adequate subcutaneous tissue. Ultimately, surgeons should follow the reconstructive ladder, reserving SIPF when simpler methods are insufficient.

Leírás
Kulcsszavak
Subcutaneous Island Pedicle Flap, Local Flaps in Dermatologic Surgery, Skin Tumour Reconstruction
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Hivatkozás
https://hdl.handle.net/2437/397852
Gyűjtemények
Theses (Faculty of Medicine)