Overview
Free flap; It is a tissue transfer that may include skin, fat, muscle or, if necessary, bone. It aims to provide volume and durability appropriate to the need, rather than just covering the surface of a large loss. In head and neck repairs, functions such as speaking and swallowing may be part of the plan. The area from which tissue will be removed is selected by taking into account the characteristics of the missing tissue and the possible effects in that area. The survival of the transplanted tissue and the adequacy of the functional result are evaluated separately. Referral to a center where relevant surgical branches, anesthesia, nursing and rehabilitation teams work together may be necessary. Sometimes additional correction attempts are also made.
What is evaluated?
- The type of missing tissue and the functions that need to be reestablished are determined.
- Examination of the suitability of blood vessels at the donor and recipient sites.
- Nutrition, accompanying diseases, and daily living requirements for the donor area are evaluated.
Approach and options
- In areas requiring thin coverage, appropriate skin and soft tissue flaps can be evaluated.
- If there is bone loss, free flaps containing bone may be considered.
- If repair with adjacent tissue or another method is sufficient, a different plan may be chosen.
Recovery and follow-up
In the hospital, the circulation of the flap is checked regularly; Poor circulation may require urgent re-operation. It is important to care for both the repaired and tissue removed areas. The need for support for feeding, speaking, walking, or arm use varies depending on the repair site. Return to work and exercise is determined gradually during check-ups.
Risks and limits
- Vascular clot and partial or complete flap loss
- Fluid accumulation in the donor area
- Wound dehiscence or infection
- Change in strength, sensation, or appearance in the donor area
The headings here do not cover all risks. Possible benefits, alternatives and personal risks should be discussed in detail during the examination.
You can ask in the consultation
- Which tissue will be taken from where and why?
- Who will carry out the rehabilitation for the targeted function?
- If the initial transfer is not sufficient, what alternatives will be considered?
Resources
- UCLH — Oral and maxillofacial surgery with reconstruction ↗
- Leeds Teaching Hospitals — ALT free flap surgery ↗
Access to sources: September 2026. The content has been prepared for general information purposes.