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The Anatomical Location of Postoperative Forehead Flap Pedicle Bleeding

A prospective histologic study examining the microvasculature of 25 harvested PMFF pedicles was performed from 2011 to 2013 with institutional review board waiver. Anticoagulation was preoperatively discontinued, 10days for aspirin and3days for others. A traditional 20-mmwide pedicle was centered on the path of an ultrasonically identified supratrochlear artery. The full-thickness pedicle included periosteum and was sectioned by a scalpel. Complete intraoperative hemostasis was achieved with bipolar electrocautery. Donor and recipient sites were stitched, and the entire PMFF was dressed with a pressure bandage. All patients had some postoperative pedicle bleeding. Although the end point was to demonstrate the vascular source of bleeding, it is interesting to note that this small study showed no anecdotal trend between the amount of postoperative bleeding and vital signs, medications, demographics, or defect size.