Clinical experiences in free flap transfer.

In this series of 62 free flap transfers, 48 (80%) have been successful. There have been a significant number of vascular complications, 39% of which the majority were arterial thrombosis. Fifty per cent of those which thrombosed were salvaged on exploration and revision of the vessels. The frequency of complications has diminished with experience but they remain significantly high. Free flap surgery demands considerable expertise in both donor site dissection and microvascular technique. Two surgeons with microvascular experience, each with adequate assistance, are preferred and ready availability of operating room is essential. Close postoperative observation and readiness to revise anastomoses are equally important. About 50% of failed free flap sites have been repaired by application of split skin grafts.