Use of the Tunable Dye Laser to Delay McFarlane Skin Flaps

Mechanism of the delay phenomenon: tissue protection is mediated by heme oxygenase-1

“…Although strong efforts have been made to understand flap pathophysiology (23) to develop novel strategies for improvement of flap viability, there is no distinct approach available to prevent flap necrosis. One of the most effective procedures to ameliorate flap viability is the induction of the delay phenomenon (31,32). In fact, of the numerous types of conditioning procedures tested during the past two decades, only ischemic conditioning produced convincing results (24).…”

“…Although these studies have shown improvement of flap survival independent of the nature of the conditioning procedure, pharmacological interventions may vary in effectiveness to enhance flap survival and may in general not achieve the degree of tissue protection, which is observed after surgical conditioning procedures (22,31). Thus surgical ischemic conditioning has been suggested the predominant experimental and clinical method to improve flap survival (6,32).…”

Evaluation of Flashlamp-Pumped Pulsed-Dye Laser (585 nm) in Nonsurgical Delay of Dorsal Rat Cutaneous Flaps

“…These two studies demonstrated that a dorsal rat skin flap could be delayed without any incision, and interruption of blood flow at the periphery of a skin flap was the main stimulus for delay phenomenon. Based on the same principles, Odland et al 10 and Odland and Rice 11 used argon tunable dye and potassium titanyl phosphate lasers operating at 577 nm and 532 nm, respectively, to treat the distal perimeter of proposed flap and improved dermal flap survival. However, continuous wave argon tunable dye laser often exceeds the 1-millisecond thermal relaxation time of cutaneous microvessels and caused nonselective superficial and deep skin thermal damage.…”

“…This feature enabled the use of laser as a less invasive and nonsurgical method in the delay phenomenon. Successful use of the argon tunable dye laser, 10 potassium-titanyl-phosphate laser, 11 erbium yttrium-aluminum-garnet laser, 12 carbon dioxide laser, 12 and flashlamp-pumped pulsed-dye laser [13][14][15] has been reported in the delay of random pattern rat skin flaps.…”

Comparison of flash lamp pulsed-dye laser (585 nm) and conventional surgery in the delay of random dorsal rat flaps

“…Odland and associates studied a rat McFarlane flap model and found that the delay by a continuous wave argon pumped-dye laser operating at 577 nm was as effective as the delay by surgery [6]. Using this laser, one may obtain a pulsed or continuous (CW) light of various wavelengths covering the visible spectral range.…”