Effectiveness of Different Surgical Flap Delay Methods and Their Systemic Toxicities

Area of Science:

• Plastic Surgery
• Tissue Engineering
• Experimental Surgery

Background:

• Surgical flap delay is crucial for preventing flap loss and preparing larger flaps.
• No definitive gold standard surgical delay method exists in current literature.
• Investigating flap survival and DNA damage parameters is essential for optimizing surgical techniques.

Purpose of the Study:

• To compare three distinct surgical delay methods for their efficacy in enhancing flap survival.
• To evaluate the impact of different delay techniques on circulating mononuclear leukocytes as a marker of DNA damage.
• To identify the most effective surgical delay strategy in a rat McFarlane flap model.

Main Methods:

• Twenty-four male Sprague-Dawley rats were allocated into four groups, including a control.
• All rats received a 10 × 3 cm modified McFarlane flap.
• Measurements of flap surface area, biopsies, and blood samples were collected on days 7 and 14 for control and delay groups, respectively.

Main Results:

• The bipedicled group exhibited significant reductions in necrosis and apoptosis compared to the control group.
• The tripedicled group showed a significant reduction in necrosis only, relative to the control.
• All experimental delay groups displayed elevated levels of DNA damage compared to the control group.

Conclusions:

• Incisional surgical delay procedures, without flap elevation, proved effective in enhancing flap survival.
• The bipedicled incisional surgical delay emerged as the most effective method in the McFarlane experimental flap model.
• Two-staged surgical delays may potentially elevate the risk of systemic toxicity.