Response on: How We Do It: Alar Advancement Flap for Small Medially Based Alar Defects

Abstract

I nterpolation flaps are often required for large and deep defects. They require a two-stage procedure. During the first stage, the primary defect is covered by the flap body, which is supplied by a robust vascular pedicle. After sufficient vascularization to the wound bed has developed, a second stage is performed in which the pedicle is divided and the flap is fully inset. In the time between stages, bleeding from the flap is a potential complication. Interventions to mitigate bleeding include diligent cautery, additional suture placement, the application of pressuring dressings, and wrapping petrolatumimpregnated gauze around the stalk of the pedicle. 1,2 However, each of these techniques carries the risk of compromising the vascular supply of the flap.Herein, we propose a safe, reliable, accessible, and relatively inexpensive method to minimize bleeding while maintaining vascular patency when using interpolation flaps. As an alternative to the petrolatum-infused gauze method, we have used 2-octyl cyanoacrylate, a commercially available wound adhesive.