Free flap neovascularization: Fact or fiction?

Excerpt

Free tissue transfer by microvascular anastomosis has, since its beginnings in the 1970s, enabled surgeons to move the necessary quality and quantity of tissues from donor to recipient areas located in many different areas of the body and with average success rates of more than 95%. Free flaps improve vascularization and promote healing. This can be crucial in body areas where the healing potential is physiologically poor (distal third of the lower leg) or is decreased because of radiotherapy, trauma, or infection. For these reasons reconstructive microsurgery is considered today to be an integral part of the complex treatment of various forms of cancer (e.g., sarcomas on trunk and extremities, head and neck, breast), acute trauma (emergency free tissue transfer), chronic infections (osteomyelitis), and congenital deformities (congenital pseudoarthrosis of the tibia). Complex microsurgical reconstructions may require additional surgeries over a prolonged period of time for functional or esthetic reasons. In such cases more precise knowledge about the safety of division of the vascular pedicle of previously transferred free flap(s) is of paramount importance. …