Complete division of the pedicle of the forehead flap is possible after one week of engraftment in selected patients

Abstract Background : Recent studies have demonstrated that early division of the forehead flap (FHF) is possible if angiography is performed or if a remnant of the pedicle is left behind. Whether or not careful selection of patients allows for complete division of the pedicle has not been studied. Objective To assess if careful selection of patients allows for early complete division of the FHF. Methods Exclusion criteria were trauma in the donor region, full-thickness defects or larger cartilage grafting. In the selected patients, complete division of the FHF pedicle was performed at early time points, when the pedicle was clinically engrafted (n=12). Results The median age of the patients was 80 (±8) years of age. The average size of the wounds was 6.6 (±4.0) cm2. Complete division of the pedicle was performed in 10 patients after 7 days, once after 8 days and once after 11 (median 7.4±1.1) days. One patient developed a wound infection, one suffered from postoperative bleeding. The latter patient was the only one who required debulking in a third surgical procedure. No necrosis or flap failures were observed. Limitations Retrospective, single-center study. Conclusion Careful selection allows for complete early division of the pedicle of the FHF.