Viability of skin flaps subjected to simultaneous chemical peel with occlusive taping

This study was undertaken to determine whether the application of a standardized chemical peel with an occlusive tape dressing to an acutely raised skin flap (as in combining rhytidectomy with chemical peel) affects skin flap viability. Thirty-six 4-cm x 4-cm dorsal skin flaps were raised on guinea pigs and sutured back into place. Eighteen of these flaps were simultaneously treated with a single application of Baker's solution and a 24-hour occlusive tape dressing. A mean of 3.1 cm2 of the nonpeeled flaps necrosed, compared with 6.3 cm2 of the peeled flaps, a statistically significant increase in tissue loss in flaps that were simultaneously chemically peeled. We conclude that application of Baker's solution with an occlusive tape dressing to an acutely raised skin flap impairs skin flap viability and may result in skin flap necrosis.