New concept flaps in the last 15 years and our revised classification of skin flaps

1. New concept flaps in the last 15 years were examined from the viewpoint of the vascularization, and the revision of our classification of skin flaps was attempted. 2. An adipofascial pedicled flap was considered to be one of clinical forms of cutaneous and fasciocutaneous flaps. 3. From the viewpoint of the vascularization, the thin flap belongs to the cutaneous flap family. Cutaneous flap (thin flap) was classified into six types, because blood vessels of the fasciocutaneous plexus were classified into six types. 4. It is difficult that a perforator-based flap is recognized as a new concept flap. We consider that the perforator-based flap belongs to the fasciocutaneous flap family. Because the name comes to be used generally as a new concept flap, the clear grounds are necessary. 5. A single pedicled venous flap, a neuroskin flap, and a neurocutaenous flap are new concept flaps whose blood supply depends on accompanying blood vessels of the cutaneous nerve and vein, and the concept of the VAF, NAF, and V-NAF flaps is systematization of the new concept flaps. In our classification, they correspond to the type II fasciocutaneous flap. 6. To maintain consistency in our flap classification, the VAF flap was changed from the venoadipofascial pedicled f-c flap to the veno-accompanying artery f-c flap. The NAF flap was changed from the neuroadipofascial pedicled f-c flap to the neuroaccompanying artery f-c flap. Moreover, the V-NAF flap was changed from the venoneuroadipofascial pedicled f-c flap to the venoneuro-accompanying artery f-c flap.