If a skin flap is raised in two or more stages, its blood supply is better than that of the flap raised in one stage. This surgical delay procedure is one of the proven method for augmentation of the skin flap survival. Clinical use of delayed skin flap has been decreased in the past few years. However, the delay phenomenon still remains as an important subject in flap research. In order to study the relationship between the length of delay and the amount of blood flow, authors made delayed flaps on the rabbit dorsal skin, and measured flap blood flow with non-invasive Laser Doppler flow metry. The sixty white New Zealand rabbits were divided into 6 groups. Delay procedure was done in 2, 3, 4, 6, 8 and 14 days respectively according to each group, and acute flaps(control) were made on the same rabbit at the day of the end of delay. Skin blood flow was increased 6 hours after flap raising.
The results obtained were as follow
1. The rapid increase of the blood flow (over 200 %) in the random skin flap occurs within the first 3 to 4 days of delay(p<0.05)
2. The effective length of delay is between 6 to 8 days of delay.
3. This study seems that the delay phenomenon does not depend on neovascularization, angiogenesis, A-V shunt closure.
4. We suggest that the locally released neurohumoral substance may play a role in skin flap viability and manifestation of the delay phenomenon.
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