The behaviour o free muscle and musculocutaneous flaps after early loss of axial blood supply.

Clinical experience has shown that a very large part of a free muscle, musculocutaneous or even osseo-musculocutaneous flap which loses its axial blood supply at ten days may survive. Vascularisation of muscle-containing flaps from the base is progressive and when a free-flap appears avascular on surface inspection careful tangential excision of the dead tissue will usually reveal surviving tissue in the deeper layers that will accept a split-skin graft or even another flap. Four illustrative cases are presented and discussed in detail.