The effect of microneedling with a roller device on the viability of cutaneous and fasciocutaneous flaps / Ahmad Adel Saeed Elsayed Abdelkhaliq ; Supervised Adel Michel Wilson , Mohammed Ahmed Hussein , Amr Ahmed Zaki

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background: Fasciocutaneous flaps are usually used in reconstruction of open wounds that can{u2019}t be closed primarily. The distal portion of a local random pattern fasciocutaneous flap has the maximum risk of ischemic necrosis because of decreased vascular perfusion, thus flap delay was proposed to avoid such undesirable outcome. The effects of various pharmacological agents and surgical delay methods have been frequently studied. Microneedling with a handheld roller device is a newly suggested treatment modality used as a preconditioning method to increase flap viability. In this study, we aimed at evaluating the effect of microneedling as a delay technique when applied directly on the flap could increase flap viability and prevent flap necrosis. Methods: Between August 2018 and March 2019, 20 patients with various defects and exposed structures were treated with cutaneous and fasciocutaneous flaps with the aid of microneedling as a preconditioning method. Each flap was divided into two equal halves (Study and Control). The Study half was exposed to preconditioning by microneedling procedure while the control half wasn{u2019}t. The process was done 3 days before surgery and on the night before surgery. Flaps were monitored postoperatively for viability based on their colour and temperature twice a day. The mean percentages of distal necrosis in the flap area was measured in cm. All patients were followed up for one monthative preparation. However, further histological studies on larger scales are recommended

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