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Measuring before closure (not after, when wound edges may approximate differently) gives the most defensible measurement for the claim

Malhotra A, Grunstein RR, Fietze I, Weaver TE, Redline S, Azarbarzin A, Sands SA, Schwab RJ, Dunn JP, Chakladar S, Bunck MC, Bednarik J, SURMOUNT-OSA Investigators

The leaks can be small or big, depending on how serious it is and the person's own situation

The direct use of protein neurotrophic factors such as HGF as therapeutic agents has two serious limitations: 1) large size and hydrophilic character precludes BBB permeability