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Although surgical delay phenomenon has been widely investigated, its pathophysiology has not been fully elucidated. Methods: In 25 Spraque-Dawley rats, an 8 × 8 cm2 epigastric skin flap consisting of 4 vertical zones A through D (farthest from vascular pedicle) was outlined. All animals were perfused twice with colored fluorescent microspheres: immediately before and after flap elevation (Acute, n = 10) and before and after pedicle ligation on POD 8 (Delayed, n = 15).After acute flap elevation, peripheral perfusion dropped significantly in zone C (0.29 ± 0.01 vs. 0.19 ± 0.04 ml g−1 min−1; P < 0.01) and zone D (0.33 ± 0.09 vs 0.01 ± 0.01 ml g−1 min−1; P < 0.01), while global flap perfusion remained unchanged. Total and regional blood flow did not change in the Delayed group after pedicle ligation.Elevation of a pedicled flap caused significant decrease in distal flap perfusion while maintaining proximal and total flap perfusion. Eight-day delay was adequate to establish sufficient flap perfusion independent of the vascular pedicle.