Simplified nomenclature for compound flaps.

The unique niche for compound flaps is their potential role for the repair of massive defects that demands the simultaneous restoration of multiple, missing tissue types. These complex flaps can be sorted into two major classes, and their subtypes on the basis of their means of vascularization are described. (1) Solitary vascularization, the composite flap: "multiple tissue components with a single vascular supply and dependent parts." (2) Combined flaps: (a) Siamese flaps: "multiple flap territories, dependent due to some common physical junction, yet each retaining their independent vascular supply"; (b) conjoint flaps: "multiple independent flaps, each with an independent vascular supply, but linked by a common indigenous source vessel"; and (c) sequential flaps: "multiple independent flaps, each with an independent vascular supply, and artificially linked by a microanastomosis." Many technical modifications that have improved or will improve the reliability of these flaps should not be confused as distinct flap types, but rather acknowledged as variations that can be more conveniently classified for the purposes of improved communication and research by using this basic schema as a guideline.