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Reconstruction with microvascular free flaps by visiting microsurgeons.
Barbara S Lutz1, Jan B Wieslander
1Department of Plastic Surgery, University Hospital Orebro, Orebro, Sweden.
Summary
Visiting microsurgeons can safely perform free flap reconstructions in remote areas. This approach offers a reliable alternative to patient transport, reducing costs and improving access to specialized care.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Free flap reconstruction is a complex procedure requiring specialized microsurgical expertise.
- Access to microsurgeons can be limited in remote or underserved areas.
- Patient transportation for specialized surgery incurs significant costs and risks.
Purpose of the Study:
- To evaluate the safety and reliability of free flap reconstructions performed by visiting microsurgeons.
- To assess the feasibility of this model in areas lacking local microsurgical expertise.
- To determine the potential benefits for patients in remote locations.
Main Methods:
- Twenty-two free flap reconstructions were performed by visiting microsurgeons.
- Procedures focused on head and neck (21) and lower leg (1) soft tissue defects.
- Flap types included fibula, radial forearm, anterolateral thigh, iliac crest, and latissimus dorsi.
- Local surgeons and nurses provided preoperative and postoperative care under the visiting microsurgeon's guidance.
Main Results:
- All 22 free flap reconstructions were successful, with only one partial flap loss.
- No pedicle revisions were required.
- Visiting microsurgeons stayed briefly, facilitating efficient care delivery.
Conclusions:
- Free flap reconstructions by visiting microsurgeons are a safe and reliable option.
- This model provides a viable solution for remote areas lacking local microsurgical specialists.
- It potentially reduces patient travel burdens and associated expenses.