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Unveiling The Mysteries Of The Chimera Flap After Almost A Semicentennial
Geoffrey G. Hallock, MD.
Sacred Heart Hospital, Allentown, PA, USA.

Purpose: The term "Chimera Flap" was "coined" by this presenter long ago. Only now has it become accepted as an unique entity. The personal impact of this concept over the past decades has never before been tabulated, so this review now would be appropriate to ascertain its true validity. Methods: A chart review of all local muscle and fasciocutaneous/perforator flaps and all free flaps utilized within this private practice from 1982-2021 was undertaken to reveal the actual frequency of selection of a Chimera flap, its composition, and intent. Results: In this practice, a chimera flap was used in 11 of 1685 local flaps (0.7%) and 55 of 1108 free flaps (4.9%), or (2.4%) of all flaps. Of these 66 flaps, a muscle-skin combination was used in 30(45.5%), muscle-muscle 24(33.6%), skin-bone 7(10.6%), and skin-skin 5(7.6%). The predominant recipient region was the lower extremity [36(54.50%)]. Overall, most permitted surface area augmentation [26(39.4%)] or independent component insetting such as "fill" [25(37.9%)], followed by 3-dimensional reconstructions in 12(18.2%). Conclusion: Since the advent of the "true" perforator flap, indigenous muscle-skin combinations have become more common since readily available. Most commonly these were employed as microsurgical tissue transfers where an added advantage was that only a single recipient site was needed to service multiple flaps relying on but a single donor site. Chimera flaps are exceptional for enhancing coverage capabilities as well as simultaneous independent 3-dimensional insetting. However, most routine problems can be more simply solved, as the Chimera flap has only infrequently been required.


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