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Studies have highlighted that advanced imaging modalities and other technologies such as image-guided stereolithographic biomodeling can substantially improve flap planning, flap harvest, and operative outcomes.
A large variety of animal models of soft tissue flap ischaemia have demonstrated the ability of HBO to preserve acutely ischaemic tissue and improve flap survival, while others have demonstrated substantially accelerated and improved quality of healing of muscle, tendon, peripheral nerve and bone.
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The evolution of the understanding of perforator flap anatomy has increased their clinical use and improved flap design.
Closure with a tongue flap has the following advantages: formation of a highly vascularized flap, improved flap survival rate even for a large fistula, and extremely low incidence of postoperative disorders of tongue movement, perception, and taste.
The Cook-Swartz implantable Doppler flow system provides continual feedback on vascular pedicle status, which in turn provides rapid assessment of minute-to-minute changes in flap vasculature that may allow intervention before total vascular occlusion and expeditious reexploration for threatened flap failure, possibly improving flap salvage.
The optimal tuning of adaptive flap controller can improve adaptive flap control performance on uncertain operating environments, but the optimization process is usually time-consuming and it is difficult to design proper optimal tuning strategy for the flap control system (FCS).
The preoperative analysis of perforator arteries enables the precise identification of their caliber and course, and so to select the optimal one(s), in order to improve the flap's design therefore reducing operating time.
AcSDKP has been shown to improve skin flap survival and accelerate wound healing [ 151].
In such cases, additional semilunar incision is useful in improving the flap mobility.
It was also reported that Sal B enhanced angiogenic processes on SVR cells through up-regulation of VEGF and VEGF receptors genes [ 9], enhanced angiogenesis in vitro and improved skin flap survival in Sprague-Dawley rats [ 10], and improved the integrity of microvessels after ischemia [ 11].
This bilobed flap design could improve the arc of flap rotation and the mobility of the flap so it could cover wide and deep defects.
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