Timing of reconstruction

INTRODUCTION The timing of flap reconstruction is critical to the reconstructive effort. A technically perfect flap done at an imperfect time can result in a suboptimal outcome or even total flap loss. This type of failure can result in significant donor site morbidity, loss of a first-line option for reconstruction, increased physiologic and mental stress for the patient, and an increase in the complexity of the reconstruction problem. The patient must be optimized for surgery in a systematic way. This involves both systemic physiologic optimization as well as local optimization of the wound.