Avoiding free flap failure

To obtain up-to-date statistics on free flap success rates, a survey of 644 consecutive free flaps performed by nine expert microsurgeons was conducted in 1991. Analysis of the failures shed light on the current problem areas. Because operative experience is the most important factor related to improved success rates, a questionnaire aimed at probing the experts for the lessons learned as their success rates improved was sent to 12 expert microsurgeons. From this source of data, and from the author's experience, a breakdown of the causes of free flap failure is given.