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ensures both protection of the pedicle as well as prevention of direct compression as well as dessication. This
technique should be applied to flaps at high risk for major complication, including those exposed to long
operative times, pre-existing vascular disease, and flaps requiring anastomotic revisions.

DECLARATIONS
Authors’ contributions
Concept and design: Iorio ML
Data acquisition and analysis: Diamond S
Manuscript preparation: Kovar A
Critical revision and completion of manuscript: Kovar A, Diamond S, Iorio ML

Availability of data and materials
Data were strictly obtained from medical records, in accordance with the privacy policy and code of ethics
at our institutions.

Financial support and sponsorship
None.

Conflicts of interest
All authors declare that there are no conflicts of interest.

Ethical approval and consent to participate
The study was approved by the BIDMC Institutional Review Board (2017-P-000253).

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

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