How does one prevent flap necrosis?

Tue, 05/18/2010 - 12:14 — enlittedo

I just started doing CT grafts and I do alot of split thickness. The tissue is often thin and I had a couple of flaps necros. How can this be prevented?

General Surgical Topics

Fri, 08/06/2010 - 08:35 — Mental Foramen

Where are your flaps necrosing?

Are you talking about the donor or recipient site? If you are talking about the donor site, you may get some necrosis depending on your harvest technique.

If you are talking about the recipient site, it sounds like you are doing a Langer or CPF technique. If you are getting necrosis here, you are likely causing it with your periosteal release when making split thickness incisions or your flap could be too narrow. Experience will help improve your split thickness technique.

You could avoid this problem alltogether by using a tunnel technique and generously undermining the mucosa. This will allow your tunnel to be positioned coronally after the CTG is placed.

Fri, 08/06/2010 - 05:01 — Tom House DDS MD

Preventing Flap Necrosis: Blood Supply

Dont make flaps to thin and wide incisions work best. Also dont drop release incisions over roots.

Sat, 05/29/2010 - 13:25 — shazlovely

Prevention of flap necrosis: Wide flaps and do not make to thin.

Wide flaps to maintain blood supply, try and avoid verticals.

Also dont make your flap to thin or perf your flap.