Complete division of the pedicle of the forehead flap is possible after 1 week of engraftment in selected patients

Background: Recent studies have demonstrated that early division of the forehead flap (FHF) is possible if angiography is performed or a remnant of the pedicle is left behind. Whether or not careful selection of patients allows for complete division of the pedicle has not been studied. Objective: To assess if careful selection of patients allows for early complete division of the FHF. Methods: The exclusion criteria were trauma in the donor region, full -thickness defects, or a larger cartilage grafting. In the selected patients, complete division of the FHF pedicle was performed at early time points, when the pedicle was clinically engrafted (n = 12). Results: The median age of the patients was 80 years +/- 8. The average size of the wounds was 6.6 cm 2 +/- 4.0. The complete division of the pedicle was performed in 10 patients after 7 days, 1 patient after 8 days, and 1 patient after 11 days (median 7.4 days +/- 1.1). One patient developed a wound infection, and 1 suffered from postoperative bleeding. The latter patient was the only 1 who required debulking in a third surgical procedure. No necrosis or flap failures were observed. Limitations: Retrospective, single -center study. Conclusion: Careful selection allows for complete early division of the pedicle of FHF. (JAAD Int 2021;2:511.)