Flaps and Microsurgery — Blood Supply, Perforators, and Surgical Strategy

Episode DescriptionThis episode reviews the core principles of flaps and microsurgery, focusing on blood supply, tissue movement, and reconstructive decision-making.Topics include random vs axial pattern flaps, local flap geometry, the delay phenomenon, and key designs such as advancement, rotation, transposition, interpolation, V-Y, and Limberg flaps. The episode also covers the reconstructive ladder vs reconstructive elevator, emphasizing how defect analysis guides surgical strategy.Muscle and fasciocutaneous flaps are reviewed through the Mathes-Nahai and Cormack-Lamberty classifications, with discussion of donor-site morbidity, perforator flaps, the Gent Consensus, perforasome theory, propeller flaps, keystone flaps, and tissue expansion.Microsurgical principles include Carrel’s triad, vessel preparation, suture technique, ischemia, flap monitoring, and how to distinguish arterial insufficiency from venous congestion after free tissue transfer.Part of Dr. Lara’s Plastic Surgery Compendium — a high-yield audio reference for plastic surgery trainees and surgeons.DisclaimerThis podcast is intended for educational purposes only and is designed for medical students, residents, fellows, and practicing healthcare professionals. It is not intended to provide medical advice, diagnosis, or treatment for any individual patient. The content presented reflects general surgical principles and should not be used as a substitute for formal medical training, clinical judgment, or consultation with qualified healthcare professionals. Listening to this podcast does not establish a physician–patient relationship.