Clinical Analysis of the 269 Cases of Free Flap

Jung, Ki Hwan; Sohn, Ho Sung; Lee, Keun Cheol; Park, Jung Min; Kim, Jeong Tae; Kim, Seok Kwun

Abstract

Free flap operations have been done for reconstruction or wound coverage as the aspect of both functional and structural problem solving. We have studied the 269 cases of free flap performed in Dong-A University Hospital from March 1990 to February 2002. In our study, the analysis was designed into 3 periods (1st stage: 1990-1994, 2nd stage: 1995-1999, 3rd stage: 2000-2002), and about age, donor site, application site, causative disease, success rate, morbidity, onset time of postoperative flap circulation insufficiency and its cause, etc. In our study, there was no difference in ratio of donor site, application site, and causative disease of free flap operation in each period, the LD free flap and TRAM free flap were the most common operation in the 269 cases of free flap operations. Recently thin perforator based free flaps were used more than myocutaneous or fasciocutaneous ones. Most of all postoperative flap circulation insufficiency were found within 48 hours after the operation, especially between 4 and 9 hours after the operation. The success rate of 3rd stage was 98.3% which was higher than 1st & 2nd stage (90.5% & 92.7%). This could be up to both the more intensive flap monitoring for example laser Doppler and the more rapid solution of poor circulation such as exploration or drainage of hematoma. These outcome can provide some information to plan and manage the free flap operations.