title: Fate of a second perforator free flap used to salvage failure of the first perforator free flap.
abstract: Perforator flaps should no longer be considered an exotic or complicated option for microsurgical tissue transfer. However, despite a proper design and attention to detail, as with any free flap, failure can be anticipated sometimes to occur. If a free flap is then still indicated, the big question is what to do next? In our series of 314 perforator free flaps over the past decade, 21 (7%) total failures occurred. A second free flap was attempted for 17 (81%) of these cases. Overall these were successful for 16 (94%) patients, including 11 perforator free flaps that were 100% successful. The anterolateral thigh (ALT) free flap proved to be the "workhorse" alternative. It can be concluded that if failure of a free flap can best be rectified by a second free flap, failure of a perforator free flap can also be reliably salvaged by a second perforator free flap.
authors.affiliation: Division of Plastic Surgery, Sacred Heart Hospital, Allentown, Pennsylvania.
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Hallock
mesh_terms: D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006085:Graft Survival; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures; D012042:Registries; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome