Free flap failures.

A retrospective analysis of 75 consecutive free flap patients, operated on during 1989-1990, was performed to find out more about factors associated with free flap failure or immediate vascular complications. The overall failure rate was 9.3% (7/75) and the immediate vascular complication rate 22.7% (17/75). Sixteen patients required explorative surgery during the first postoperative day. The results were statistically analysed to find factors promoting either failure or vascular complications. Pre-operative infection of the recipient site or prolonged operation time correlated with flap failure. The use of a vein graft or long per-operative ischaemia correlated with immediate vascular complications. It is interesting that many factors often blamed for failure (age, body mass, history of cardiovascular disease, smoking, or previous irradiation of the recipient site) were not significant in this study.