Once in place, the skin edges are approximated and total closure is performed with 0 Vicryl sutures without tension. A Quill suture is run through the periphery of the flap after the insetting for a final closure, and dermabond is applied. Two drains are left in the back and 1 gram of vancomycin is applied to the cervical wound.
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Once again capillary refills are checked to ensure there was no compression of the blood supply. The patient is transferred to recovery in a semi-recumbent position as to not put any tension on the flap.
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