Delay in Neurovenous Flaps Experimental and Clinical Experience

Abstract: The objective of this study was to examine the effects ofthe standard surgical delay in the flaps based on the cutaneousbranches of the vascular axis around a superficial sensory nerve. Thedelay procedure was experimentally tested in rats and subsequentlyused in patients.In the experimental study, the survival of a delayed inferiorepigastric neurovenous flap was compared with that of a nondelayedinferior epigastric neurovenous flap. One type of clinically applicable delay pattern (standard bipedicled technique) was employed. A3
3 cm flap was raised in 20 female Wistar rats assigned randomlyto 2 groups. Each group consisted of 20 flaps. The standard bipedicled delay pattern increased the percentage survival of thedelayed inferior epigastric neurovenous flap. The survival percentage of the delayed flaps was 59.8 185.0 (P 0.5). The histologicfindings of the skin revealed that our delay procedure enhanced theperfusion of the flap by dilating the arterial network.Stimulated by our experimental findings, we used the islandbipedicled surgical flap delay or combined strategic-standard delayin the distally pedicled sural flap successfully on 9 cases.Key Words: delay, neurovenous flap, sural flap, tissue defect

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