Tissue transplantation is followed by a critical postoperative phase in which increased attention and gentle treatment of the flap is essential. In order to achieve improved healing of the transplants postoperatively, ischemic conditioning is performed, the so-called wrapping/dangling maneuver (flap training). The affected leg is wrapped tightly and left hanging at increasing intervals over a period of 5 days. The ischemia provoked in this way modulates the oxygenation of the tissue. This leads to increased angiogenesis and thus blood flow and ultimately better healing of the transplants.

By means of detailed intravital metabolic examinations, the time window could be optimized for the first time in the world's only prospective randomized study to date, thus shortening the hospital stay and reducing the general postoperative risk.

(Neubert, N. et al., Journal of Reconstructive Microsurgery, 32(04), 262-270)

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