Surgical delay and arachidonic acid metabolites: evidence for an inflammatory mechanism: an experimental study in rats

Complications and Outcome After Thoracodorsal Axial Pattern Flap Reconstruction of Forelimb Skin Defects in 10 Dogs, 1989–2001

“…Surgical delay of skin flaps has been reported to increase flap survival 15 by increasing capillary blood flow to the distal portion of the delayed skin flap, 16 with the maximal effect of vessel dilatation occurring in the zone of choke arteries 14,17 . In a retrospective study of axial pattern flaps, delay procedures were used in 2 of 5 caudal auricular axial pattern flaps, with no improvement in total surviving flap length 12 .…”

Vascular Delay Revisited

“…Murphy et al 51 showed in a rat skin flap model that surgical delay produced an increase in the production of arachidonic acid metabolites, with a derangement of the normal equilibrium between the vasodilating metabolite prostaglandin E 2 and the vasoconstricting metabolite prostaglandin F 2␣ , Plastic and Reconstructive Surgery • May 2007 and a marked increase in the vasoconstrictive substance thromboxane. During the delay period of 14 days, there was a gradual decrease in tissue levels toward normal.…”

Impact of Arteriogenesis in Plastic Surgery: Choke Vessel Growth Proceeds via Arteriogenic Mechanisms in the Rat Dorsal Island Skin Flap

“…Inflammation, as indicated by the levels of arachidonic acid metabolites, has also been suggested to have a key role in the vascular changes and protective aspects of the delay procedure [31]. Interestingly, by examining tissue oxygen levels, hypoxia was found to not be prerequisite to increased vascularity [21], but that blood rerouting, inflammation, and angiogenesis accounted for the protective benefits of the delay procedure.…”