[Free flaps in elective reconstructive surgery over a 20 year period].
OBJECTIVE
The purpose of this study was to analyze the evolution of the practice of free flaps in the treatment of tumoral and traumatic pathologies.


METHODS
This retrospective study was realized on 328 free transfers. The authors compared two periods each of 10 years: series 1 concerns 176 flaps realized from March 12th 1981 to March 13th 1991 (already published); series 2 concerns 152 flaps realized from December 1st 1994 to November 30th 2004.


RESULTS
We noticed a decrease of the number of free flaps for lower limbs, a stabilization in the head and neck area and a clear increase in mammary reconstruction. Three donor sites were used in 89% of the cases: latissimus dorsi, forearm and rectus abdominis flaps. Others were used only one to seven times, for specific indications. Some surgical tactics saw their indication decrease (semi-free flap or "apple turnover" technique), others appeared (Y anastomoses). The number of failures decreased from one series to the other (from 5,7 to 2,6%).


CONCLUSIONS
The variety of the flaps remains restricted. The choice is due to the constancy of their vascular anatomy, the size of the pedicles and the reproducibility of their teaching in a University Hospital.
Pradier
J-P
JP
Service de chirurgie plastique et maxillofaciale, hôpital d'instructions des armées Percy, 101, avenue Henri-Barbusse, 92141 Clamart cedex, France. jean-philippe.pradier@wanadoo.fr
Revol
M
M
Servant
J-M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D014947:Wounds and Injuries / Q000601:surgery