Is Early Compression Therapy after Perforator Flap Safe and Reliable?

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Vascular Surgery

Background:

• Surgeons often avoid early flap manipulation due to concerns of circulatory compromise.
• Early compression may offer benefits like dead space collapse, hematoma evacuation, edema reduction, and flap stabilization.
• This study evaluates the impact of early flap compression on physiology and outcomes.

Purpose of the Study:

• To assess the effect of early postoperative compression on flap physiology and patient outcomes.
• To determine if early compression impacts hemodynamics of the pedicle in flap surgery.

Main Methods:

• A custom-made compression garment applying 30-35 mmHg was used from postoperative days 3-5 in 48 patients.
• Compression was applied to the flap, extremity, or trunk.
• Flap outcomes, pedicle flow velocity, and volume were measured before and after compression.

Main Results:

• No flap complications were observed during early compression and ambulation.
• No statistically significant differences were found in flow velocity (29.21 vs. 29.42 cm/s) or volume (7.13 vs. 6.56 cm³/s) before and after compression.
• Early ambulation was safely achieved.

Conclusions:

• Postoperative compression with a 30-mmHg garment is safe for extremity reconstruction.
• Early compression does not adversely affect perforator hemodynamics.
• This method can be safely implemented before patient ambulation.