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[PURPOSE OF REVIEW] To highlight three clinical arenas in which head and neck free-flap compromise is encountered and acted upon: nonoperative, operative and postoperative realms. [RECENT FINDINGS] Time to identification and intervention i…

This study was conducted to evaluate the outcomes of re-exploration procedures done after head and neck microvascular flap reconstructions. This is a retrospective review of 109 flaps in 106 patients (three patients had two flaps each) that…

[BACKGROUND]  Many microsurgeons fear high complication rates and free flap loss when vein grafting is necessary to restore blood flow at the recipient site. The aims of this study were to comparatively analyze surgical outcomes of interpos…

Micro-vascular flaps have been used for the repair of challenging defects for over 45 years. The risk of failure is reported to be around 5-10% which despite medical and technical advances in recent years remains essentially unchanged. Prec…

[BACKGROUND] Microvascular tissue transfer is a common reconstructive procedure. We designed a bioelectrical impedance assessment (BIA) system for quantitative analysis of tissue status. This study attempts to verify it through the animal m…

[BACKGROUND] The majority of hindquarter amputation defects can be reconstructed with local anterior or posterior thigh flaps. Less than 5% of soft tissue defects require free flap reconstruction after tumour resection. Lower extremity fill…

[OBJECTIVES] Free flap surgery is an essential procedure in soft tissue reconstruction. Complications due to vascular compromise often require revision surgery or flap removal. We present hyperspectral imaging (HSI) as a new tool in flap mo…

Free flap reconstruction is a common procedure with success rates greater than 99%. However, vascular complications may occur, resulting in flap failure. For this reason, early detection of vascular compromise is crucial for flap salvage. V…

[BACKGROUND] The aim of this study was to report the first case of acute facial allograft transplantation (facial allograft transplantation) failure with allograft removal and autologous free-flap reconstruction. [METHODS] A 49-year-old fe…

[BACKGROUND] Even though the benefit of free tissue transfer is uncontested in complex reconstructive cases, vascular compromise and/or flap failure remain a challenge for the surgeon and identification of possible risk factors can aid in t…

[BACKGROUND] Clinical examination remains the cornerstone for postoperative monitoring of free flaps but is highly dependent on the surgeon's ability and experience. Duplex echography provides a noninvasive objective evaluation of tissue pe…

Advances in free flap reconstruction of complex head and neck defects have allowed for improved outcomes in the management of head and neck cancer. Technical refinements have decreased flap loss rate to less than 4%. However, the potential …

Management of pediatric iatrogenic arterial occlusions can be challenging clinically, leading to chronic complications such as claudication and limb length discrepancy. We report the case of a 6-month-old female patient who had experienced …

[BACKGROUND] Understanding factors impacting successful salvage of a compromised free flap. [METHODS] Multi-institutional review of free flap reconstructions for head and neck defects (n = 1764). [RESULTS] Free flap compromise rate: 9% (n…

[UNLABELLED] Patients with diabetes mellitus and peripheral vascular disease have high rates of thrombogenic vessels. The implantable (Cook) Doppler in lower extremity reconstruction can optimize microsurgical outcomes in this population. …

Postoperative monitoring of deep inferior epigastric perforator (DIEP) flaps for breast reconstruction using noninvasive tissue oximetry enables timely recognition of vascular compromise. This may limit ischemic tissue damage, minimizing po…

[BACKGROUND] Few studies have evaluated clinical outcomes of novice surgeons trained in a microsurgical training program. Herein, we describe successful free flap reconstructions performed by trainees who completed a structured microsurgica…

[BACKGROUND] Early detection of vascular compromise following free flap microsurgical reconstruction is essential. This can lead to timely reoperations and flap salvage. Both arteries and veins are monitored postoperatively with implantable…

Microvascular free flaps are considered the gold standard in head and neck reconstructive surgery. Myofascial flaps, in particular, are useful in certain oral and maxillofacial reconstruction cases, where mucosal regeneration over the trans…

Reconstruction of posttraumatic soft tissue defects has been revolutionized after the application of microvascular free flaps. However, standard flaps are limited in size and may not completely cover the defect. Flap expansion which is indi…