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Delaying the flap also can enhance the length that may be efficiently transferred. In this process, elevate the flap in 2 stages instead of 1, permitting approximately 7-14 d between the 2 procedures. However, this interval of vasoconstriction doesn't occur at the second stage. The flap typically is designed longer and wider than is expected to be necessary. Theories explaining the delay phenomenon include vasodilation attributable to the sympathectomy and a hyperadrenergic state lasting 18-36 h after a flap is raised.
Clinical statement is the most effective technique to assess a flap. A particularly pale flap could signify arterial insufficiency, whereas a blue flap may be secondary to a failure of venous outflow. The Crane principle is an idea related to prefabrication. Two additional assessments usually used to evaluate viability are capillary refill and war After profitable flap design and implementation, monitor the flap for viability as early recognition of ischemia is essential in preventing subsequent flap necrosis, thus flap failure.
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