Hautlappen

Hautlappen, literally meaning “skin flaps,” are portions of skin and underlying tissue that are surgically mobilized and transferred to cover a defect at another site. A key distinction of a flap is that it maintains its own blood supply during transfer, unlike a skin graft, which relies on the recipient bed to revascularize.

Classification and types

Hautlappen can be local, regional, or distant. Local flaps move within the area around the wound using tissues that share blood supply with the defect. Common local flap designs include advancement, rotation, and transposition flaps. More complex flaps are designed as axial flaps, which depend on a named vessel, or perforator flaps, which rely on perforating arteries. When a flap is completely detached and transferred with its blood vessels reconnected at the recipient site, it is known as a free flap and requires microsurgical anastomosis.

Indications and techniques

Hautlappen are used to reconstruct defects after trauma, oncologic resections, burns, or congenital conditions. They provide robust tissue coverage, better contour, and preserved sensation in some cases. The choice of flap depends on defect size, location, required tissue type, and donor-site morbidity. Techniques aim to minimize tension and preserve blood supply, while possible complications include partial or complete flap necrosis, infection, hematoma, and donor-site issues.

Historical context and relevance

The concept of skin flaps developed alongside advances in reconstructive surgery, with modern practice increasingly incorporating free and perforator flaps to improve outcomes. Hautlappen remain a foundational element of reconstructive options across clinical specialties.