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Terminal necrosis of the most distal part of the interposed flap is potentially a serious complication, but total necrosis of the flap can occur owing to twisting or thrombosis of the main arterial or venous inflow or more commonly the venous outflow, which can occur acutely or several days later.
Total necrosis of brain cells is not observed at post-mortem.
This protocol is similar to our fractionated dosing schedule and we observed severe vascular and perivascular tissue damage, which progressed to almost total necrosis down to a depth of 3 mm below the skin surface (Fig.

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