Free Tissue Transfer in the Private Practice Setting: A Review of 100 Patients

Abstract

Although free tissue transfer is a well-established method of reconstruction for difficult tissue defects, the technique is not yet widely embraced in the private practice setting. Reasons for this include concern over the possibility of flap loss and other complications, the time required for these procedures, and the perceived need for a microsurgical team. The results of free tissue transfer in 100 patients in a single practitioner private practice setting were assessed. Charts were reviewed and data recorded including major and minor complications, American Society of Anesthesia rating, operative time, intensive care unit and postoperative hospital stay, estimated blood loss, and transfusion requirements. Indications included breast reconstruction, the management of chronic wounds, and acute trauma. There were three complete flap losses and three partial flap losses. There were 22 major complications in 21 patients and 17 minor complications. The results of this study compare favorably with those compiled from 36 prior reports. Free tissue transfer has taken its place in the reconstructive armamentarium as the procedure of choice in many reconstructive situations due to its reliability and versatility. This form of reconstruction can be safely offered to patients in any practice situation by surgeons who are trained in and comfortable with free tissue transfer techniques.

Simplifying Arterial Coupling in Microsurgery—A Preclinical Assessment of an Everter Device to Aid with Arterial Anastomosis

“…The use of microsurgical techniques is commonplace nationwide and free tissue transfers are performed with high success. 1,2 The popularization of microsurgery is in part due to improvements in technology that have allowed free tissue transfers to become more successful and versatile over time. For example, better instrumentation, suture material, and microscope optics allow for anastomosis of submillimeter vessels, intraoperative laser angiography provides real-time assessment of tissue perfusion, and discovery of arterial perforasomes has expanded flap options while limiting donor site morbidity.…”