Early Experience with External Negative Pressure Delay in Free Anterolateral Thigh Perforator Flap Reconstruction

• Type of Material: Article
• Authors: Ciara A. Brown, Emory University; Paul Ghareeb, Emory University
• Language: English
• Date: 2021-01-01
• Publisher: American Society of Plastic Surgeons
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/GOX.0000000000003606
• Title of Journal or Parent Work: Plastic and Reconstructive Surgery - Global Open
• Volume: 9
• Issue: 6
• Start Page: e3606
• End Page: e3606
• Keywords: negative pressure therapy; planned flap; external negative pressure; open wounds; vessel size and density; noninvasive delay phenomenon; wound healing; closed wounds; blood flow
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Negative pressure therapy has been utilized in the treatment of open and closed wounds to increase blood flow and improve wound healing. More recently, external negative pressure has been shown to induce a noninvasive delay phenomenon in animal models by increasing vessel size and density within a planned flap, leading to improvement in flap survival. Although successful in animal models, this new method of delay has not been demonstrated in clinical practice. We present our initial experience with preoperative external negative pressure delay of free anterolateral thigh flaps in upper extremity reconstruction to detail the technique and safety profile of this innovative new technique. External negative pressure delay has the potential to provide results similar to those of traditional surgical delay, while being cost effective, safer, and more convenient for patients. More research is needed to investigate the clinical benefit and cost effectiveness of external negative pressure delay.