A retrospective review of 14 patients receiving 15 free flaps during initial surgery or within 24 hours proposes three indication groups: spare-part tissue use, immediate coverage of critical structures, and flow-through flap revascularization.
Key findings
- Among 15 flaps, 7 (47%) used spare parts, 3 (20%) covered critical structures, and 5 (33%) provided flow-through revascularization. Flap success was 87%, complications 47%, functional recovery averaged 5 months (2-11), and hospital stay 15 days (8-39). Some cases preserved more distal amputation levels.
Why this matters globally
The indication framework can structure urgent orthoplastic decisions and maximize otherwise discarded tissue, but requires microsurgical, resuscitation, and rehabilitation capacity.
Thai researcher contribution
A surgeon affiliated with Somdech Phra Pinklao Hospital, Royal Thai Navy, collaborated with US centers on the emergency-microsurgery experience and framework. The cohort spans two centers and should not be represented as wholly Thai data.
Limitations to consider
Only 14 patients were included, with no control group and substantial selection bias. Functional recovery is broadly defined, injuries and follow-up vary, and the success rate cannot isolate timing effects from expertise or injury severity.
Verify the original sources
MicrosurgeryRead the original article↗DOI: 10.1002/micr.70263