Microvascular Reconstruction: Evidence-Based Procedures

Microvascular free tissue transfer is the best modality of replacing composite tissue defects with composite vascularized tissue. Wound healing, functional reconstruction, rehabilitation, and cosmesis are best accomplished when the tissue defect is replaced by free tissue. The reconstructive tissue can be tailored to the defect and is harvested from outside the often radiated pretreated reconstructive field. Evidence to support the use of free tissue transfer in head and neck defects is not of the highest level. This article reviews the postoperative monitoring of free tissue transfer, lateral mandibular reconstruction (fibula vs radial forearm), and functional outcomes with free tissue transfers.