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

Abstract

BackgroundRecent 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.ObjectiveTo assess if careful selection of patients allows for early complete division of the FHF.MethodsThe 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).ResultsThe median age of the patients was 80 years ± 8. The average size of the wounds was 6.6 cm2 ± 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.LimitationsRetrospective, single-center study.ConclusionCareful selection allows for complete early division of the pedicle of FHF.