title: Contradicting an established mantra:  microsurgeon experience determines free flap outcome.
abstract: BACKGROUND
  Since the inception and popularization of microsurgery in the 1960s and 1970s, it has been commonly accepted that the outcome of free tissue transfer directly correlates with surgeon experience.
  
  
  METHODS
  The clinical outcomes of three young microsurgeons at a single institution were retrospectively reviewed. Free flaps performed by these individuals were categorized according to the surgeon's years of practice and analyzed using statistical methods.
  
  
  RESULTS
  A total of 410 free flaps were identified. No correlation was found between the surgeon's years of experience and the outcomes measured.
  
  
  CONCLUSIONS
  There has been increased exposure to microsurgery during plastic surgery training at many programs, and consequently, residents have often already surpassed the learning curve. The imperfect correlation between experience and superior outcomes in medicine serves to suggest that further research in the specific underlying principles of surgical learning is needed to understand the relationship between experience and superior surgical outcomes.
authors.affiliation: Phoenix, Ariz. From the Mayo Clinic, Division of Plastic and Reconstructive Surgery, Department of Surgery.
authors.forename: Peter
authors.initials: P
authors.lastname: Kreymerman
authors.forename: Anna L
authors.initials: AL
authors.lastname: Silverman
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Rebecca
authors.forename: William J
authors.initials: WJ
authors.lastname: Casey
mesh_terms: D002983:Clinical Competence; D015331:Cohort Studies; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016014:Linear Models; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011786:Quality Control; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies