Fig. 82.
Coaptation of Flaps.
IV. Implantation of Pedunculated Flaps by Bridging
In this method the flap to be utilized in covering a defect is taken from a distant part of the body, as, for instance, from the arm. The flap thus taken at first remains attached at its distal end to the tissue of the arm by a pedicle, which is not severed until a circulation has been established between the flap and the part of the human economy to which its free end has been attached by suture, the arm being held in position in the meantime by a suitable contrivance, as shown in [Fig. 83].
Fig. 83.—Tagliacozza Harness.
These pedunculated flaps, bridging over space, may likewise be taken from the forearm, the hand, or the thoracic region.
When thoracic flaps are used they may be directly sewn at their free ends to the part to be covered, as, for instance, in the forearm or arm, or they are stitched to the forearm to be later transferred to another part of the body after their circulation had become established.
The various methods of the employment of these bridging flaps will be taken up individually in their respective places farther on.