Free Flaps

Free tissue flaps are used commonly in reconstructive surgery following removal of tumours from the head and neck.

What is a free flap?

A free flap is a graft of human tissue which is taken together with its supplying blood vessels and placed in another part of the body where it is reconnected to a blood supply by microsurgery. The picture on the right shows a bone containing free flap (from the hip) with its artery and vein before it is transferred to the patient to be inset and have its blood vessels re-connected.

Free flaps are harvested from several sites such as;

  • Arm - Radial forearm free flap [reconstructed tongue with radial forearm free flap]
  • Leg - Antero-lateral thigh flap
  • Leg - Fibula free flap (a bone containing free flap used for jaw reconstruction)
  • Hip - DCIA free flap (another bone flap for jaw reconstruction)
  • Back - Scapula / Latissimus Dorsi flap

What will it look like?

Initially the graft will be quite swollen and requires close monitoring by the doctors on the ward to check that its blood supply is working well without any problem. Over the following weeks and months the graft heals into place and settles to its final shape. The picture to the right shows a tongue which has been reconstructed with a radial forearm free flap on the right side following removal of a tongue cancer.

Jaw resection and reconstruction

Modern free flap reconstructive techniques mean that even the removal of large parts of the jaw can be effectively replaced with excellent functional and cosmetic results. The photos below show a patient with a tumour of the left jaw which has been removed and rebuilt using a bone containing DCIA free flap.

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