Current principles and trends of using axial pattern flaps in reconstructive surgery of the extremities

On the basis of published data, we identified and analyzed current principles and trends of using axial pattern tissue complexes in patients with limb defects, depending on the nature and localization of the defect, and also objectives of reconstructive surgery. Today, there are three closely related trends. The most important one is to reduce injury caused by intervention; this results in using non-free island flaps instead of the widespread use of free perfused tissue complexes. The second trend is aimed at obtaining the most favorable functional results in treating defects of the covering structures relative to similar defects of bones and muscle-tendon units. The third trend is minimizing the negative aesthetic results.