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Clinical Outcomes of Suture Delay in Forehead Flap

Isik, Daghan MD*; Kiroglu, Faruk MD; Isik, Yasemin MD; Goktas, Ugur MD; Atik, Bekir MD*

Journal of Craniofacial Surgery: January 2012 - Volume 23 - Issue 1 - p 75–77
doi: 10.1097/SCS.0b013e318240ca2a
Original Articles

The delay phenomenon is a surgical procedure performed to raise a wider skin flap and to improve the survival of skin flaps. Surgery, chemicals, sutures, and lasers can be used for the delay procedure. In this study, delayed forehead flaps created by suturing were used for coverage of nasal skin defects in eleven patients. In 7 patients, the cross-paramedian forehead flap was used to increase the extent of flap lengthening. In the first session, suture delay was performed on both sides of the forehead flap margin. In the second session, the flap was elevated and sutured to its new position, 7 to 10 days after the initial surgery. All flaps were completely viable, and patient satisfaction was optimal in all cases. The positive effect of surgical delay on flap survival has been shown in experimental and clinical studies. However, experimentally, suture delay or chemical delay procedures have been shown to be beneficial in flap survival only. Suture delay seems to be an inexpensive, effective, easily performed, atraumatic, and safe technique, especially among patients with systemic diseases such as diabetes or cardiovascular diseases, smoking patients who may lose the flap, or patients who need very wide and long flaps.

From the Departments of *Plastic Surgery, †ENT, and ‡Anesthesiology, Medical School, Yuzuncu Yil University, Van, Turkey.

Received November 6, 2010.

Accepted for publication April 7, 2011.

Address correspondence and reprint requests to Daghan Isik, MD, Yuzuncu Yil Universitesi, Tip Fakultesi, Plastik Cer. A.D. Maras Cad. 65100, Van, Turkey; E-mail:

The authors report no conflicts of interest.

© 2012 Mutaz B. Habal, MD