A flap is a unit of tissue (skin, fat, muscle, or bone) that is transferred from one site (donor site) to another (recipient site) while maintaining its own blood supply. During a free flap procedure, a.k.a. free tissue transfer, a surgeon detaches at least one vein and one artery from a specific body region, and reattaches the divided artery and vein to another region. The technique was first used in the 1960’s, and has greatly increased the success of complex surgical reconstruction procedures.
Benefits of Free Tissue Transfer / Free Flaps
The technique is used in a number of reconstructive procedures including mandibular, breast, and facial reconstructions. Some advantages of using free flaps are:
- Stable wound coverage
- Improved aesthetic and functional outcomes
- Minimal donor site morbidity
- High success rate among experienced surgeons (currently 95-99%)
Indications for Free Tissue Transfer / Free Flaps
Although there are no absolute indications for free flap reconstruction, the technique may be used in many instances of complex reconstruction procedures. Certain conditions, however, such as cardiovascular disease and connective tissue disorders, may be contraindications to a free tissue transfer procedure.
Free Tissue Transfer with Dr. Morse
Free tissue transfers are inpatient procedures; general anesthesia is most often used, though spinal anesthesia is occasionally used for lower extremity free flaps. Dr. Morse will use doppler ultra-sonography to locate vessels called perforator vessels in the part of your body that will receive the free flap. The flap is designed to be centered on these perforators, and the planned flap is clearly marked on the skin. Next, the free tissue is transferred from the donor to the recipient site, and the vein and artery from the flap are linked, or anastomosed, to the vein and artery identified at the donor site. Finally, Dr. Morse will suture the flap to the recipient, and close both recipient and donor sites.
What to Expect After Surgery
You will be monitored post-operatively for 3-7 days as you recover in inpatient care. Depending on the particular procedure, you may be recovering between 1 to 3 months before you are fully active. To a varying degree, scarring after free tissue transfer should be expected.To learn more about the benefits, costs or possible side effects of free tissue transfer surgery, contact Dr. Morse for a personal consultation.