Effects of surgical or chemical delaying procedures on the survival of proximal pedicled venous island flaps:: An experimental study in rats

To increase the survival of proximally pedicled venous island flaps, which are known to be safe only when small, we used surgical and chemical delaying procedures both individually and in combination for 7, 14, and 21 days. Survival was 1% in those flaps designated as controls, in which there was neither surgical nor chemical delay. However, it was 3%, 31%, and 68% at 7, 14, and 21 days, respectively, when surgical delay was used and 16%, 56%, and 86%, at 7, 14, and 21 days, respectively, when chemical delay was used. Survival was 32%, 84%, and 87%, at 7, 14, and 21 days when both chemical and surgical delays were used. We conclude that chemical delay is more effective than surgical delay in increasing survival of proximally pedicled venous island flaps, but the use of combined chemical and surgical delay may reduce the time required for delay.