Hussein, M., Zaki, A., Abdelkhakeq, A., Wilson, A. (2020). Evaluation of Micro-Needling as a Flap Preconditioning Modality: A Split-Flap Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 44(3), 415-419. doi: 10.21608/ejprs.2020.122295
Mohamed Ahmed Hussein; Amr Ahmed Zaki; Ahmed Adel Abdelkhakeq; Adel Michel Wilson. "Evaluation of Micro-Needling as a Flap Preconditioning Modality: A Split-Flap Study". The Egyptian Journal of Plastic and Reconstructive Surgery, 44, 3, 2020, 415-419. doi: 10.21608/ejprs.2020.122295
Hussein, M., Zaki, A., Abdelkhakeq, A., Wilson, A. (2020). 'Evaluation of Micro-Needling as a Flap Preconditioning Modality: A Split-Flap Study', The Egyptian Journal of Plastic and Reconstructive Surgery, 44(3), pp. 415-419. doi: 10.21608/ejprs.2020.122295
Hussein, M., Zaki, A., Abdelkhakeq, A., Wilson, A. Evaluation of Micro-Needling as a Flap Preconditioning Modality: A Split-Flap Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 44(3): 415-419. doi: 10.21608/ejprs.2020.122295
Evaluation of Micro-Needling as a Flap Preconditioning Modality: A Split-Flap Study
The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Cairo University, Egypt
Abstract
Background: Distal flap necrosis is a common problem that is frequently encountered by plastic surgeons. Microneedling with a handheld roller device is a minimally invasive modality that is proposed to improve distal flap circulation, it causes localized dermal injury with rupture of fine dermal and subdermal capillaries. As a result of platelet extravasation, activation and growth factors release, neoangiogenesis occurs which in turn enhances flap circulation. Our current study aims to evaluate the efficacy of micro-needling as a minimally invasive delay technique. Methods: 20 patients with various defects who met our inclusion criteria were included. The derma-roller device was used as a flap delay modality. This was done preoperatively, three days and on the night before surgery. The flap was divided into equal halves; The Study half was exposed to preconditioning by micro-needling while the control half wasn't. All patients were followed-up for one month postoperatively. Results: The mean surface area of defect (length multiplied by width in cm) was 38.9 (±20.37) the minimum was 15 while the maximum was. All patients' defects were covered by random pattern cutaneous or fascio-cutaneous flaps. The mean surface area of flap used for coverage was 59.85 (±23.78) the minimum was 28 while the maximum was 128. The average surface area of distal flap necrosis in the control side was 35% meanwhile it was 20% in the study side. Conclusions: Flap preconditioning with micro-needling might decrease distal flap necrosis and improve flap survival in random pattern cutaneous and fasciectomies flaps. It is a simple, minimally invasive modality that could be done as an out-patient procedure.
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