Reconstruction with microvascular free flaps by visiting microsurgeons.

Abstract

Twenty-two free flap reconstructions were done by one of both authors as visiting microsurgeons to a hospital a long distance away. The reconstructions were performed in the head and neck (n = 21) and the soft tissue of the lower leg (n = 1). Free flaps included: fibula (n = 8), radial forearm (n = 6), anterolateral thigh (n = 4), iliac crest (n = 1), and musculocutaneous latissimus dorsi flap (n = 3). No pedicle revision was necessary. No flap was lost completely, but one partially. Either of both microsurgeons arrived the day before reconstruction and stayed for about two days postoperatively. Preoperative investigations and postoperative care were done by the local plastic surgeons (who had no microsurgical experience), the ear, nose, and throat surgeons, and the nurses, following the regimen given by the microsurgeon. Microvascular reconstructions, done by a microsurgeon visiting from a long distance away are a reliable and safe option. This may be of advantage in remote areas where no microsurgeon is available locally, to avoid long transports for patients and the associated high costs.