A study on the effect of derotation on perforator flaps challenged with vascular compromise Randomised controlled trial

The study will include all perforator flaps having vascular compromise. The vascular compromise will be detected by clinical methods- colour, temperature, turgor, bleeding pattern and measuring blood sugar of flap (using glucometer).

The flap will be randomised to group A or B by means of computer-generated table of random numbers.  Group A will get conventional measures, namely, removal of sutures and loosening of local dressing, increase of local temperature, limb elevation, oral antiplatelet drugs (aspirin 75 mg). Group B will get conventional measures, namely, removal of sutures and loosening of local dressing, increase of local temperature, limb elevation, oral antiplatelet drugs (aspirin 75 mg), along with derotation of the flap. After 3 days, the derotated flap will be rotated into the defect. All flaps will be monitored every 6 hourly by clinical methods- colour, temperature, turgor, bleeding pattern and measuring blood sugar of flap (using glucometer). The person allocating the groups and performing the monitoring will be different from the operating surgeon.

At the end of 10 days, the surviving surface area of the flap will be measured using measuring scale and software available at https://www.sketchandcalc.com/area-calculator-app/. This will be done by a person different from the operating surgeon.

All relevant data will be collected and entered in the proforma. The data will then be tabulated using MS-Excel spreadsheet and appropriate statistical analysis will be done. SPSS 23 will be used, wherever required.