An alternative free-flap technique and 12-year follow-up

Conventional free-tissue transfer without complication requires a microsurgical facility that includes a team of trained and experienced microvascular surgeons, expensive equipment, and other associated paraphernalia. To obviate the need for an operating microscope, or even magnifying loupes, an alternative technique for free-tissue transfer has been developed by the author and utilized over the past 12 years. The method involves the use of modified fasciocutaneous flaps with long vascular pedicles. No extra training, microvascular expertise, equipment, or expense are involved, and a general plastic surgeon can utilize the technique. The procedure has had particular use in underprivileged, third-world, plastic surgery units. Advantages and disadvantages of the procedure are discussed.