Complications of the free-flap donor site from a community hospital perspective

Techniques for achieving appropriate wound healing with minimal aesthetic or functional deformity of the microsurgical flap donor site are often assumed to be of minor importance or blatantly overlooked. Surprisingly, an analysis of 115 consecutive free-tissue transfers by a single surgeon within a community hospital setting, revealed an overall donor-site complication rate of 31 percent, with significant disability from major complications occurring in 10 percent of cases. Recognition of the projected morbidity of alternative donor sites therefore deserves scrutiny, with the same intensity as does consideration for flap selection, previously done solely to fulfill the requirements of the recipient site. While flap viability has previously been the criterion for success, the future dictates that morbidity at the donor site be an equally important consideration.