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Free flap surgery: the Welsh Regional Unit experience.

N J Percival¹, P J Sykes, M J Earley

¹Welsh Regional Plastic and Reconstructive Surgery Unit, St Lawrence Hospital, Chepstow.

British Journal of Plastic Surgery

|July 1, 1989

Summary

Free tissue transfer surgery has a 91% success rate, with venous thrombosis being the most common complication but highly salvageable. Arterial occlusion is less salvageable, highlighting the importance of flap choice and surgical timing.

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Area of Science:

Microsurgery
Plastic and reconstructive surgery
Surgical outcomes

Background:

Free tissue transfer has evolved significantly since 1976.
This technique involves transferring tissue with its own blood supply to a recipient site.
It is crucial for complex reconstructions following trauma or cancer surgery.

Purpose of the Study:

To document the evolution and uses of free tissue transfer.
To analyze the success rates and influencing factors of free flap procedures.
To evaluate the outcomes of managing postoperative complications, specifically thrombosis.

Main Methods:

Retrospective review of 200 free flap procedures performed.
Analysis of factors influencing flap survival: flap type, recipient site, and timing of surgery.

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Evaluation of re-exploration rates and salvage success for postoperative complications.

Main Results:

An overall success rate of 91% was achieved in 200 free flap surgeries.
Flap survival is influenced by flap type, recipient region, and surgical timing post-trauma.
Venous thrombosis (82% salvage) was more common and better tolerated than arterial occlusion (50% salvage).

Conclusions:

Free tissue transfer is a successful reconstructive technique with a high overall success rate.
Careful consideration of flap selection, recipient site, and surgical timing is essential.
Prompt management of venous thrombosis is critical for successful flap salvage, more so than arterial occlusion.