“…However, our findings disagree with a number of much smaller series from specialized oncology centers [12,13]. Further, Howell et al, in a systematic review of FC with VRAM flaps [12][13][14][15][16] or gracilis flaps [14,15,17,18] following APR, showed weak evidence in favor of FC for previously irradiated patients though failed to show similar evidence for non-irradiated patients [2]. As noted by Howell et al, study in this area has been limited by small sample size, heterogeneous patient population, and variable definitions of wound complications.…”