Abstract
Background Due to the concern of circulation compromise, many surgeons hesitate to dangle or
challenge the flap in the early postoperative phase. In our experience, early compression
may have advantages such as collapse of dead space, evacuation of hematoma, reduction
of edema, and stabilization of flap when ambulating. In this study, the effect of
early compression of flaps with regard to flap physiology and outcome is evaluated.
Methods From postoperative day 3 to 5, a custom-made compression garment was fitted aiming
to compress with a pressure of 30 to 35 mmHg. A total of 52 patients (52 flaps) were
enrolled for the study and 48 flaps underwent early compression. The compression was
applied not only over the flap but also over the extremity or trunk. The flap outcome
as well as flow velocity and flow volume of the pedicle before and after compression
was measured and evaluated.
Results There was no flap complication during the early compression and early ambulation.
And, there was no statistical difference either in the flow velocity or in the volume
before and after the compression therapy (29.21 vs. 29.42 cm/s and 7.13 vs. 6.56 cm3/s, respectively).
Conclusion Early compression with a 30-mmHg pressure customized pressure garment after the flap
surgery does not affect the hemodynamics of the perforator and can be safely used
after extremity reconstruction before ambulation.
Keywords
perforator flap - compression of flaps - flap surgery
