Pharmacologic Methods to Reduce Postoperative Bleeding During the First Stage of the Interpolated Forehead Flap Repair: A Systematic review

What strategies are actually available to reduce pedicle bleeding in forehead flaps?
Which options are supported by evidence—and what are their limitations?

Now published in Dermatologic Surgery.

This systematic review synthesizes the literature on pharmacologic and adjunctive approaches to postoperative bleeding control in stage I forehead flaps. We identified 9 distinct strategies, each with unique mechanisms, indications, and tradeoffs between hemostasis and flap perfusion.

Key takeaway: Bleeding control in forehead flaps is not prescriptive. Strategy selection should be evidence-informed, context-dependent, and individualized to the patient and reconstruction.

Grateful to my co-authors and mentors for their collaboration.

Dr. Felipe Cerci · Médico · Dermatologia · RQE 1023 · CRM-PR 24825