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Managing the Outer Limits of Reconstruction With Microsurgical Free Tissue Transfer

Managing the Outer Limits of Reconstruction With Microsurgical Free Tissue Transfer Abstract • Six patients had major deficits reconstructed with microsurgical free tissue transfer. In contrast to some opinions that free tissue transfer is a "method of last resort," these patients were selected for microsurgical reconstruction as a method of first choice due to the qualities desired in the reconstruction, the reliability of the technique, and the desire to minimize the functional or aesthetic deficit at the donor site. Microsurgical techniques allowed a reconstruction in these cases that would have been difficult or impossible by conventional techniques, while they markedly improved the quality and reliability of the reconstruction and decreased the donor morbidity. Microsurgical free tissue transfer has been reported to have a success rate of 94% in centers where a significant volume of surgery is done. We believe the continued refinement of microsurgical techniques and their increased application will improve the results of reconstruction in a large category of severe traumatic and cancer defects. (Arch Surg 1984;119:673-679) References 1. Daniel RK, Taylor GI: Distant transfer of an island flap by microvascular anastomosis . Plast Reconstr Surg 1973;52:111-117.Crossref 2. Taylor GI, Daniel RK: The anatomy of several free flap donor sites . Plast Reconstr Surg 1975;56:243-253.Crossref 3. Harii K, Ohmori K: Free skin flap transfer . Clin Plast Surg 1976;3:111-127. 4. Harii K: Microvascular free flaps for skin coverage: Indications and selection of donor sites . Clin Plast Surg 1973;10:37-54. 5. Shaw WW: Microvascular free flaps: The first decade . Clin Plast Surg 1983;10:3-20. 6. Acland RD: The free iliac flap . Plast Reconstr Surg 1979;64:30-36.Crossref 7. Katsaros J, Schusterman M, Acland RD, et al: The lateral arm flap: An experimental and clinical study . Trans VIII Int Cong Plast Reconstr Surg , 1983, pp 132-134. 8. Maxwell GP, Steuber K, Hoopes JE: A free latissimus dorsi myocutaneous flap: Case report . Plast Reconstr Surg 1978;62:462-465.Crossref 9. Manktelow RT, McKee N: Free muscle transplantation to provide active finger flexion . J Hand Surg 1978;3:416-426.Crossref 10. Taylor GI: The current status of free vascularized bone grafts . Clin Plast Surg 1983;10:185-208. 11. Teot L, Bosse JP, Moutarrege R, et al: The scapular crest pedicled bone graft . Int J Microsurg 1981;3:257-262. 12. Taylor GI, Ham FJ: Free vascularized nerve graft . Plast Reconstr Surg 1976;57:413-425.Crossref 13. Mathes SJ, Buchanan R, Weeks PM: Microvascular joint transplantation with epiphyseal growth . J Hand Surg 1980;5:586-589.Crossref 14. Jurkiewicz MJ: Vascularized intestinal graft for reconstruction of the cervical esophagus and pharynx . Plast Reconstr Surg 1965;36:509-517.Crossref 15. Flynn MB, Acland RD: Free intestinal autografts for reconstruction following pharyngolaryngoesophagectomy . Surg Gynecol Obstet 1979;149: 858-862. 16. Robinson DW, MacLeod A: Microvascular free jejunum transfer . Br J Plast Surg 1982;35:258-267.Crossref 17. Gluckman JL, McDonough J, Donegan JO, et al: The free jejunal graft in head and neck reconstruction . Laryngoscope 1981;91:1887-1895.Crossref 18. Nassif TM, Vidal L, Bovet JL, et al: The parascapular flap: A new cutaneous microsurgical free flap . Plast Reconstr Surg 1982;69:591-600.Crossref 19. Acland RD, Schusterman M, Godina M, et al: The saphenous neurovascular free flap . Plast Reconstr Surg 1981;67:763-774.Crossref 20. Ohmori K, Sekiguchi J, Ohmori S: Total rhinoplasty with a free osteocutaneous flap . Plast Reconstr Surg 1979;63:387-394.Crossref 21. Banis JC, Acland RD: Clinical applications of the scapular skin and osteocutaneous flap . Trans VIII Int Cong Plast Reconstr Surg , 1983, pp 137-139. 22. MayJW, Chait LA, Cohen BE, et al: Free neurovascular flap from the first web of the foot in hand reconstruction . J Hand Surg 1977;2:387-393.Crossref 23. O'Brien BM, Brennen MD, MacLeod AM: Microvascular free toe transfer . Clin Plast Surg 1978;5:223-237. 24. Zuker RM, Manktelow RT, Palmer JA, et al: Head and neck reconstruction following resection of carcinoma, using microvascular free flaps . Surgery 1980;88:461-466. 25. Serafin D, Voci VE: Reconstruction of the lower extremity: Microsurgical composite tissue transplantation . Clin Plast Surg 1983;10:55-72.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Managing the Outer Limits of Reconstruction With Microsurgical Free Tissue Transfer

Banis, Joseph C.; Acland, Robert D.
Archives of Surgery , Volume 119 (6) – Jun 1, 1984
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References (29)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1984.01390180039007
Publisher site
See Article on Publisher Site

Abstract

Abstract • Six patients had major deficits reconstructed with microsurgical free tissue transfer. In contrast to some opinions that free tissue transfer is a "method of last resort," these patients were selected for microsurgical reconstruction as a method of first choice due to the qualities desired in the reconstruction, the reliability of the technique, and the desire to minimize the functional or aesthetic deficit at the donor site. Microsurgical techniques allowed a reconstruction in these cases that would have been difficult or impossible by conventional techniques, while they markedly improved the quality and reliability of the reconstruction and decreased the donor morbidity. Microsurgical free tissue transfer has been reported to have a success rate of 94% in centers where a significant volume of surgery is done. We believe the continued refinement of microsurgical techniques and their increased application will improve the results of reconstruction in a large category of severe traumatic and cancer defects. (Arch Surg 1984;119:673-679) References 1. Daniel RK, Taylor GI: Distant transfer of an island flap by microvascular anastomosis . Plast Reconstr Surg 1973;52:111-117.Crossref 2. Taylor GI, Daniel RK: The anatomy of several free flap donor sites . Plast Reconstr Surg 1975;56:243-253.Crossref 3. Harii K, Ohmori K: Free skin flap transfer . Clin Plast Surg 1976;3:111-127. 4. Harii K: Microvascular free flaps for skin coverage: Indications and selection of donor sites . Clin Plast Surg 1973;10:37-54. 5. Shaw WW: Microvascular free flaps: The first decade . Clin Plast Surg 1983;10:3-20. 6. Acland RD: The free iliac flap . Plast Reconstr Surg 1979;64:30-36.Crossref 7. Katsaros J, Schusterman M, Acland RD, et al: The lateral arm flap: An experimental and clinical study . Trans VIII Int Cong Plast Reconstr Surg , 1983, pp 132-134. 8. Maxwell GP, Steuber K, Hoopes JE: A free latissimus dorsi myocutaneous flap: Case report . Plast Reconstr Surg 1978;62:462-465.Crossref 9. Manktelow RT, McKee N: Free muscle transplantation to provide active finger flexion . J Hand Surg 1978;3:416-426.Crossref 10. Taylor GI: The current status of free vascularized bone grafts . Clin Plast Surg 1983;10:185-208. 11. Teot L, Bosse JP, Moutarrege R, et al: The scapular crest pedicled bone graft . Int J Microsurg 1981;3:257-262. 12. Taylor GI, Ham FJ: Free vascularized nerve graft . Plast Reconstr Surg 1976;57:413-425.Crossref 13. Mathes SJ, Buchanan R, Weeks PM: Microvascular joint transplantation with epiphyseal growth . J Hand Surg 1980;5:586-589.Crossref 14. Jurkiewicz MJ: Vascularized intestinal graft for reconstruction of the cervical esophagus and pharynx . Plast Reconstr Surg 1965;36:509-517.Crossref 15. Flynn MB, Acland RD: Free intestinal autografts for reconstruction following pharyngolaryngoesophagectomy . Surg Gynecol Obstet 1979;149: 858-862. 16. Robinson DW, MacLeod A: Microvascular free jejunum transfer . Br J Plast Surg 1982;35:258-267.Crossref 17. Gluckman JL, McDonough J, Donegan JO, et al: The free jejunal graft in head and neck reconstruction . Laryngoscope 1981;91:1887-1895.Crossref 18. Nassif TM, Vidal L, Bovet JL, et al: The parascapular flap: A new cutaneous microsurgical free flap . Plast Reconstr Surg 1982;69:591-600.Crossref 19. Acland RD, Schusterman M, Godina M, et al: The saphenous neurovascular free flap . Plast Reconstr Surg 1981;67:763-774.Crossref 20. Ohmori K, Sekiguchi J, Ohmori S: Total rhinoplasty with a free osteocutaneous flap . Plast Reconstr Surg 1979;63:387-394.Crossref 21. Banis JC, Acland RD: Clinical applications of the scapular skin and osteocutaneous flap . Trans VIII Int Cong Plast Reconstr Surg , 1983, pp 137-139. 22. MayJW, Chait LA, Cohen BE, et al: Free neurovascular flap from the first web of the foot in hand reconstruction . J Hand Surg 1977;2:387-393.Crossref 23. O'Brien BM, Brennen MD, MacLeod AM: Microvascular free toe transfer . Clin Plast Surg 1978;5:223-237. 24. Zuker RM, Manktelow RT, Palmer JA, et al: Head and neck reconstruction following resection of carcinoma, using microvascular free flaps . Surgery 1980;88:461-466. 25. Serafin D, Voci VE: Reconstruction of the lower extremity: Microsurgical composite tissue transplantation . Clin Plast Surg 1983;10:55-72.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Jun 1, 1984

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