Abstract
Purpose: The first 50 free flap operations performed at our clinic by the same surgical team were reviewed and assessed as to the cause and location of the defects, donor sites, complications and results. An attempt was then made to determine what could be learned from this experience.
Material and Methods: There were 46 males and 4 females who underwent free flap operations (mean age, 28.5 years; range 6 to 56 years). The lower extremity was the most frequent site of defect (72.5%). The next most frequent sites were the arm and the hand (27.5%). Trauma was by far the most common cause. Latissimus dorsi and forearm flap were the most useful flaps. Fractures in the wound were present in 26 patients.
Results: The fate of the flaps has been analysed. In two latissimus dorsi flap emergency re-exploration was performed and were successfully managed. Two flaps, underwent necrosis, due to thrombosis at the site of arterial anastomosis. Two flaps were lost due to inappropriate blood flow of the recipient vessels. Other complications included pressure ulcer, infection, and hematoma. The overall survival rate of the 50 cases was 92%.
Discussion: Limb reconstructive surgery has significantly improved and expanded with the use of microsurgical techniques. Evaluation of the recipient vessels is always the first priority. The choice of the flap, specially regarding the length and size of the pedicle is also very crucial in order to achieve good results. In addition important factors seemed to be: improvement in techique of micro-vascular anastomosis, diseased vessels, vascular spasm, hypotension, postoperative edema, and hematoma. We believe that an “orthoplastic” approach in covering soft tissue defects is beneficial.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
