Comparing the Effects of Pedicle Torsion on Axial or Perforator Flaps; Improving the Perforator Flap Resistance to Pedicle Torsion with Delay Phenomenon

Abstract

In conclusion, the resistance to torsion of the axial flap pedicle pattern was greater than that of the perforator pedicle pattern, and the delay procedure was not an effective method for improving flap resistance to torsion.

Safe delayed procedure of nipple reconstruction in poorly circulated nipple

“…Such methods include the delayed procedure principle, which can increase flap vascularity, and have been studied via animal experiments for over a century. In various studies, vasoconstriction occurred during the initial 3‐hour delay period following flap elevation; however, a marked increase in vessel size was found between 48 and 72 hours, and up to 1 week later, widening of the vessel lumen was found on angiography and histology, with an increase in the diameter of choke vessels . There are ongoing efforts to increase the viable area of the flap through such delayed phenomena …”

“…16,17 The presentstudy attempted to address the most fundamental | 131 size was found between 48 and 72 hours, and up to 1 week later, widening of the vessel lumen was found on angiography and histology, with an increase in the diameter of choke vessels. 1 There are ongoing efforts to increase the viable area of the flap through such delayed phenomena. 9 Generally, if ischemia/necrotic change and/or congestion are identified in the flap following nipple reconstruction, tension is reduced by a stitch-out, in expectation of finding improved blood supply.…”

“…From an esthetic perspective, the reconstruction of thenipple‐areolar complex (NAC) is vital being the final step in breast reconstruction designed to restore the patient's body image . For NAC reconstruction, there are ongoing studies on various surgical techniques using autologous or artificial material for improving outcomes that can satisfy the position, symmetry, size, shape, projection, and color of the NAC.…”

“…From an esthetic perspective, the reconstruction of thenipple-areolar complex (NAC) is vital being the final step in breast reconstruction designed to restore the patient's body image. [1][2][3][4][5] For NAC reconstruction, there are ongoing studies on various surgical techniques using autologous or artificial material for improving outcomes that can satisfy the position, symmetry, size, shape, projection, and color of the NAC. However, various factors such as the location of the scar, smoking status, reconstruction surgery methods, and in particular, a history of radiation therapy, occasionally lead to complications.…”

Direction of Flap Rotation in Propeller Flaps: Does It Really Matter?

“…Factors such as kinking, twisting, and tension on the pedicle are well known causes of flap failure and can be harmful even in nonanastomotic conventional flap and perforator flap models. 7,[9][10][11] When rotation is only needed up to 90°, it may not matter whether more than one pedicle is preserved. However, when the flap needs to be rotated 180°it is actually safer to divide all perforators except one to prevent potential hazards like pedicle kinking and one perforator compressing the other.…”