Free flap surgery: the Welsh Regional Unit experience.

The evolution and uses of free tissue transfer since 1976 are documented. Two hundred free flaps have been performed with an overall success rate of 91%. The factors which may influence survival are the type of flap used, the recipient region and the timing of surgery following trauma. Twenty-five percent of cases required re-exploration postoperatively, of which 78% were successfully salvaged. Venous thrombosis was the commonest problem and appears better tolerated than arterial occlusion. Eighty-two percent of venous thromboses were salvaged compared with only 50% of arterial failures.