title: Comparing the effects of pedicle torsion on axial or perforator flaps; improving the perforator flap resistance to pedicle torsion with delay phenomenon.
abstract: BACKGROUND
  The torsion of the flap's pedicle is one of the most common conditions causing vascular compromise. We aimed to compare the resistance to torsion of axial flap pedicle and perforator pedicle patterns. In the second part of the study, we investigated whether the delay phenomenon is an effective method for improving perforator flap resistance to pedicle torsion.
  
  
  METHODS
  In the first phase, 90 male Wistar rats were randomly divided into two groups: perforator and axial. Bilateral groin flaps were elevated in the axial group and bilateral posterior thigh perforator-based flaps were elevated in the perforator group. Viable flap areas were compared at 90, 180, 270, 360, and 720 degrees of pedicle rotation. Microangiographic and histopathological studies were performed.
  
  
  RESULTS
  As a result, necrosis was seen following earlier rotation in the perforator group and viable flap areas were also lower. In the second phase, after delay procedure, the perforator flaps were exposed to 270, 360, and 720 degrees of pedicle rotation. With the delay procedure, no significant difference in viable flap areas was observed.
  
  
  CONCLUSIONS
  In conclusion, the resistance to torsion of the axial flap pedicle pattern was greater than that of the perforator pedicle pattern, and the delay procedure was not an effective method for improving flap resistance to torsion.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Bektas
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Ozlenen
authors.initials: O
authors.lastname: Ozkan
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Anı
authors.initials: A
authors.lastname: Cinpolat
authors.affiliation: Department of Pathology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Ibrahim Cumhur
authors.initials: IC
authors.lastname: Bassorgun
authors.affiliation: Department of Pathology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ciftcioglu
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ozkan
mesh_terms: D000792:Angiography; D000818:Animals; D004195:Disease Models, Animal; D006085:Graft Survival; D008297:Male; D009336:Necrosis / Q000473:pathology*; D061525:Perforator Flap / Q000098:blood supply*; D051381:Rats; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures; D013997:Time Factors; D014022:Tissue Survival; D054159:Torsion, Mechanical; D014945:Wound Healing