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Microsurgery and tissue transfer

Microsurgical free tissue transfer allows tissue to be transferred from one part of the body to another and allows for its immediate vascularization. This enables reconstruction and wound closure to be achieved where grafts would not be a viable option, e.g. when covering bare bone or tendon. ‘Free’ flaps are distinguished from local and pedicle flaps that remain attached to the body and their blood supply during positional transfer. The anastomosis of blood vessels, an artery and vein, can require specialized techniques and instruments and a prolonged anaesthetic. Nevertheless, in experienced hands, microsurgical free tissue transfer has a high rate of success, in the region of 95-99%. The technique is particularly useful in the following conditions:

• stable coverage of exposed vital structures, e.g. in complex tibial fractures • vascularized bone, e.g. for mandible reconstruction • functional tissue, e.g. muscle for facial reanimation • bulky soft tissue, e.g. breast reconstruction or to obliterate cavities.