**5. Care of flaps and donor site**

The use of flaps in reconstruction requires special care in terms of surveillance of perfusion and integration. The pediculate flaps usually do not jeopardize the perfusion, but sometimes a minor venous congestion can be expected. As a preventive measure, any intent must be done to avoid tension or compression of the vessel that perfuses the flap. The free flaps require special attention due to the risk of arterial or venous thrombosis and flap failure. Strict vigilance during the first 72 h after surgery and searching for signs of an early venous congestion or arterial occlusion can detect early failure of the flap and may permit in many cases a successful intervention to preserve the flap. The use of Doppler monitoring may help to reach that goal.

The donor site when skin grafted may be left secured and covered with wet gauze up to 8 days to reach adherence of the tissue. Sometimes small bleeding is expected with no need of a revision surgery. If the donor site is primary closed, surveillance of a compartment syndrome is necessary especially if it is closed is under tension.
