Free flaps in elective reconstructive surgery over a 20 year period

The purpose of this study was to analyze the evolution of the practice of free flaps in the treatment of tumoral and traumatic pathologies. This retrospective study was realized on 328 free transfers. The authors compared two periods each of 10 years: series 1 concerns 176 flaps realized from March...

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Bibliographic Details
Published in:Annales de chirurgie plastique et esthétique 2007-04, Vol.52 (2), p.77-88
Main Authors: Pradier, J-P, Revol, M, Servant, J-M
Format: Article
Language:fre
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Female
Humans
Male
Middle Aged
Neoplasms - surgery
Reconstructive Surgical Procedures
Retrospective Studies
Surgical Flaps
Wounds and Injuries - surgery
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Summary:The purpose of this study was to analyze the evolution of the practice of free flaps in the treatment of tumoral and traumatic pathologies. This retrospective study was realized on 328 free transfers. The authors compared two periods each of 10 years: series 1 concerns 176 flaps realized from March 12th 1981 to March 13th 1991 (already published); series 2 concerns 152 flaps realized from December 1st 1994 to November 30th 2004. We noticed a decrease of the number of free flaps for lower limbs, a stabilization in the head and neck area and a clear increase in mammary reconstruction. Three donor sites were used in 89% of the cases: latissimus dorsi, forearm and rectus abdominis flaps. Others were used only one to seven times, for specific indications. Some surgical tactics saw their indication decrease (semi-free flap or "apple turnover" technique), others appeared (Y anastomoses). The number of failures decreased from one series to the other (from 5,7 to 2,6%). The variety of the flaps remains restricted. The choice is due to the constancy of their vascular anatomy, the size of the pedicles and the reproducibility of their teaching in a University Hospital.
ISSN:0294-1260