Local skin flaps have revolutionized reconstructive surgery. Mechanical loading is critical for flap survival: Excessive tissue tension reduces blood supply and induces tissue necrosis. However, skin flaps have never been analyzed mechanically. Here we explore the stress profiles of two common flap designs, direct advancement flaps and double back-cut flaps. Our simulations predict a direct cor...

BACKGROUND The development of flap necrosis distally remains a concern during microsurgical flap transfers because, at least in part, of decreased perfusion. Microvascular fragments (MVFs) are microvessels isolated from adipose tissue that are capable of improving tissue perfusion in a variety of tissue defects. The aim of this study was to determine whether the transplantation of MVFs in a dor...

BACKGROUND Surgical flap delay is commonly used in preconditioning reconstructive flaps to prevent necrosis. However, staged procedures are not ideal. Pharmacologic up-regulation of angiogenic and arteriogenic factors before flap elevation poses a nonsurgical approach to improve flap survival. METHODS Male Sprague Dawley rats were divided into control (n = 16), surgical delay (Delay), AdNull,...

CASE REPORT A 3-year-old male neutered Domestic Shorthair cat was evaluated for a skin mass of approximately 2 × 3 cm arising from the right dorsolateral aspect of the tail at the junction between the proximal and middle one-thirds of the tail length. Incisional biopsy sample was consistent with granulomatous inflammation. The granuloma was surgically excised with 5 mm margins of normal skin. T...

OBJECTIVE To examine our outcomes with skin paddle survival using pectoralis myocutaneous flaps in reconstruction of the head and neck. The pectoralis major myocutaneous flap has been associated with a notable incidence of distal skin necrosis and flap loss. Our experience has been favorable compared with that reported in the literature. METHODS Retrospective medical record review of 81 cases...

Over the last decade, lymph node flap (LNF) transfer has turned out to be an effective method in the management of lymphoedema of extremities. Most of the time, the pockets created for LNF cannot be closed primarily and need to be resurfaced with split thickness skin grafts. Partial graft loss was frequently noted in these cases. The need to prevent graft loss on these iatrogenic wounds made us...

BACKGROUND Insufficient arterial blood flow is the one cause of flap necrosis. Cilostazol is an inhibitor of phosphodiesterase III and increases cyclic AMP level in vascular smooth muscle cell causing vasodilation. Therefore, effect of cilostazol is expected to improve the viability of the flap. METHODS Double blinded randomized controlled trial was conducted. The study was to compare the sur...

despite all modern surgical techniques, skin flap that is considered as the main method in most reconstructive surgeries puts the skin tissue at danger of necrosis and apoptosis derived from ischemia. therefore, finding a treatment for decreasing the apoptosis derived from flap ischemia will be useful in clinic. in present study, we evaluated the effect of azelaic acid 20% and finasteride on ex...