Comparison of incisional delay patterns on a rat random flap model

Area of Science:

• Plastic Surgery
• Surgical Techniques
• Tissue Engineering

Background:

• Surgical delay is a technique to improve flap survival by preconditioning tissue.
• Different patterns of incisional delay exist, but their comparative efficacy needs further investigation.

Purpose of the Study:

• To compare the effectiveness of different incisional delay patterns on flap survival.
• To evaluate the impact of preserving specific skin edges on flap viability.

Main Methods:

• Twenty-eight animals were divided into four groups: control, bilateral skin edge preserved delay (BSEPD), unilateral skin edge preserved delay (USEPD), and superior skin edge preserved delay (SSEPD).
• Incisional delay was performed by creating incisions around flap edges, leaving specific sections intact without undermining.
• Flaps were elevated and reinserted after two weeks, with outcomes assessed via necrotic area measurement, microangiography, and histology.

Main Results:

• The mean necrotic flap area was lowest in the USEPD group (7.54%), followed by BSEPD (16.94%), SSEPD (23.34%), and control (50.6%).
• Microangiographic imaging revealed more prominent vessels in the delay groups compared to the control.
• SSEPD was found to be ineffective in improving flap survival compared to USEPD and BSEPD.

Conclusions:

• Unilateral skin edge preserved delay (USEPD) is a highly effective method for improving flap survival.
• Preserving skin edges, particularly unilaterally, enhances vascularity and tissue viability during surgical delay procedures.
• Superior skin edge preserved delay (SSEPD) is not recommended for improving flap survival.