ABSTRACT
I. INTRODUCTION Free tissue transfer has become an extremely reliable technique for the broad spectrum of reconstructive defects that challenge plastic surgeons. Free tissue transfer had its beginnings in reconstructing defects for which no other local tissues were available, such as in distal lower extremity reconstruction. Free tissue transfer rapidly extended to head and neck reconstruction and breast reconstruction as success rates and functional results were improved compared to previous local tissue options. Contrary to these anatomical areas, local tissue transfers have remained the primary method of reconstruction for defects of the abdomen and perineum (1-4). The current literature on free tissue reconstruction of the abdomen and perineum is limited but evolving, with most references citing a small patient series or case report (5-11). In performing free tissue transfers, there are a multitude of potential donor tissues. The contemporary reconstructive microsurgeon now chooses donor tissues based on maximizing both the functional and aesthetic results at the recipient site. At the same time, the surgeon chooses donor tissues that limit the functional and aesthetic defects at the donor site. For this reason, we continue to see free tissue transfers used for defects, such as in the abdomen and perineum, that have been commonly reconstructed with local tissues. This chapter will review the current use of free flaps in abdominal and perineal reconstruction.
