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Delay of Flap

Synonyms

Delay of flap; Delay phenomenon; Flap delay; Surgical delay; Vascular delay

Definitions

Surgical interruption of a portion of the blood supply in a preliminary stage prior to tissue transfer.

Principle

Surgical delay is a perfusion preconditioning technique in reconstructive soft tissue flap surgery. In this technique, the flap’s vascular supply is partially disrupted in a separate procedure prior to a subsequent transfer procedure.

Purpose

The purpose of the technique is to allow for enhanced flap length and viability in reconstruction. Flap delay has been used for nearly 500 years in reconstructive surgery for reliably transferring a greater amount of harvested tissue than one would be able to otherwise (Myers and Cherry 1967). The method of delaying the flap involves incising the borders of the flap with or without partial subcutaneous elevation and leaving it in situ for a duration of time, usually 10–14 days (Milton 1969), at which time delay