Effectiveness of Different Surgical Flap Delay Methods and Their Systemic Toxicities.

Yildiz K., Mirapoglu S. L., Kilic U., Guneren E., Kocyigit A., Kirazoglu A., ...More

The Journal of craniofacial surgery, vol.32, no.5, pp.1946-1950, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 5
  • Publication Date: 2021
  • Doi Number: 10.1097/scs.0000000000007444
  • Journal Name: The Journal of craniofacial surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.1946-1950
  • Keywords: Apoptosis, DNA damage, flap survival, necrosis, surgical delay, DNA-DAMAGE, SKIN-FLAP, VASCULAR DELAY, VIABILITY, PERFUSION, FLOW
  • Bezmialem Vakıf University Affiliated: Yes


Objective: The surgical flap delaying has been shown to be effective in preventing partial flap loss or in preparing larger flaps. However, there is no gold standard flap delay method in the literature. In this study, the authors aimed to compare 3 types of surgical delay methods to determine which model would increase more flap survival. The authors also investigated the effect of delay methods on circulating mononuclear leukocytes as a parameter of DNA damage. Methods: Twenty-four Sprague-Dawley male rats were divided into 4 groups. All subjects had a 10 x 3 cm modified McFarlane flap. Surface area measurements, biopsies, and blood samples were taken on the day of sacrification; 7th day for the control group and 14th day for delay groups. Results: Between incisional surgery delay groups, a significant difference was found in necrosis and apoptosis in the bipedicled group, and only necrosis in the tripedicled group compared to the control. In terms of DNA damage, it was found higher in all experimental groups than in the control group. Conclusions: Both incisional surgical delay procedures' results were meaningfully effective when only incisions were made without the elevation of flaps. In conclusion, bipedicled incisional surgical delay seems to be the most effective method in McFarlane experimental flap model whereas two-staged surgeries may increase the risk of systemic toxicity.