What is the procedure for a bivalve (two-part) fasciocutaneous flap?

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From the Guidelines

A bivalve fat flap is a surgical technique used in plastic and reconstructive surgery to repair tissue defects, involving creating two connected flaps of fat tissue that remain attached to their blood supply, as described in general surgical principles 1. The procedure involves several key steps, including identifying and marking the donor site where fat will be harvested, administering local anesthesia, and making two incisions to create the bivalve configuration, with each flap containing subcutaneous fat and maintaining its own blood supply.

  • The flaps are then carefully elevated while preserving the vascular pedicle,
  • rotated to cover the defect area, and
  • sutured into place. This technique is particularly useful for filling contour deformities or covering small to medium-sized wounds, and is considered in the context of managing complex wounds, such as those associated with fracture-related infections or pressure injuries 1. The bivalve approach offers advantages over single flaps because it provides better volume and contour matching while maintaining robust blood supply to both segments, which improves survival of the transferred tissue and leads to better healing outcomes, as is critical in preventing infection and promoting wound healing in patients with compromised tissue integrity 1. Recovery typically involves monitoring for complications such as infection or flap necrosis, with suture removal occurring 7-14 days after surgery depending on the location and healing progress, and may involve a multidisciplinary approach to manage symptoms and improve quality of life, particularly in patients who are not candidates for debridement and flap reconstruction 1.

From the Research

Bivalve Fat Flap Procedure

There are no research papers to assist in answering this question as the provided studies do not mention a "bivalve fat flap" procedure.

Related Information on Fat Flaps and Local Anesthesia

  • The provided studies discuss the use of local anesthesia in various surgical procedures, including skin grafts and local flaps 2, 3, 4, 5.
  • They highlight the importance of careful patient selection and surgical technique in reducing the risk of flap compromise 6.
  • Local anesthesia can be a safe and effective option for certain procedures, such as facial fat grafting 4 and forehead flap reconstructive maxillofacial procedures 5.
  • Ultrasound-guided local anesthetic nerve blocks can be used to reduce the need for alternative analgesics and minimize complications 5.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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