Circulation

The precise details of the circulation relevant to a wound are critical to recovery and healing. Many long-lasting or permanent sequelae arise out of circulatory insufficiency during the period of reactive swelling following injury. Venous insufficiency is potentially just as lethal to tissues as ischaemia, but much more common and frequently overlooked. Fortunately, there are several ways to assist venous drainage. When sufficient circulation cannot be demonstrated in an isolated tissue flap, the next technical consideration must be the reattachment of the flap as a graft, to provide access to a new capillary perfusion.