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Updated: Jun 23, 2025
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A Model of Free Tissue Transfer: The Rat Epigastric Free Flap
Published on: January 15, 2017
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An Institutional Analysis of Early Postoperative Free Tissue Transfer Takeback Procedures
Angelica Hernandez Alvarez1, Daniela Lee1, Erin J Kim1
1Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Journal of Reconstructive Microsurgery
|June 18, 2024
Summary
Reexploring free tissue transfer flaps after surgery is rare but risky. Salvage is more successful when microvascular issues or isolated venous injuries are addressed promptly with a single operation.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Free tissue transfer reexploration is infrequent but linked to higher failure rates.
- Understanding factors influencing takeback versus no takeback procedures is crucial.
- Identifying trends in reexploration can improve salvage success.
Purpose of the Study:
- To compare free flaps requiring reexploration with those that did not.
- To analyze trends in reexploration techniques for successful salvage.
- To identify patient and procedural factors associated with flap failure and salvage.
Main Methods:
- Retrospective review of free tissue transfers (2011-2022).
- Comparison of reexplored flaps (within 30 days) versus a control group (no reexploration).
- Univariate and multivariate logistic regression analyses were employed.
Main Results:
- 62 out of 1,213 flaps (5%) required reexploration.
- Salvage rate for reexplored flaps was 87.10% (54 out of 62).
- Significant differences noted in flap indication, type, location, venous anastomoses, cause of failure, vessel type, and salvage technique.
Conclusions:
- Breast reconstruction in patients without hypercoagulability or prior history had fewer reexplorations.
- Salvage success was higher in cases without microvascular compromise or with isolated venous injury requiring one operation.
