title: Prevention of necrosis of adjacent expanded flaps by surgical delay.
abstract: Although expanded flaps have been shown to survive longer than unexpanded flaps, flap necrosis still occurs, particularly when a deep back cut has been made. Overcautious design can avoid necrosis but leads to inefficient usage of the expanded flap. In this study, we tested a surgical delay method to prevent partial necrosis and maximize the use of the expanded flap. Ten patients with 13 expanders were included in this series. The surgical delay was performed 2 weeks before the final flap transfer. The survival of the delayed flaps was compared with that in previous cases without surgical delay. All 13 expanded flaps exhibited complete survival, which was significantly better than the 27.5% partial flap necrosis observed in nondelayed cases. Surgical delay can decrease the risk of necrosis in an expanded flap caused by a back cut and can thus maximize flap use.
authors.affiliation: From the Plastic and Reconstructive Department, Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Hainan
authors.initials: H
authors.lastname: Zhu
authors.forename: Yun
authors.initials: Y
authors.lastname: Xie
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.forename: Bin
authors.initials: B
authors.lastname: Gu
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.forename: Tao
authors.initials: T
authors.lastname: Zan
authors.forename: QingFeng
authors.initials: Q
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D009336:Necrosis / Q000209:etiology / Q000517:prevention & control; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000473:pathology*; D013997:Time Factors; D015626:Tissue Expansion / Q000379:methods*; D055815:Young Adult