Free flaps in the aged and infirm

Some of the most dramatic advances in reconstructive surgery have involved microvascular free-flap transfers. Although initial studies stressed the need for the procedures to be restricted to the healthy, with no evidence of vascular disease, it has become apparent that such restrictions need not apply if adequate patient care is available. Refinements of technique and development of new operations have made the free flap available to all. In particular, the procedure has been found to have unique benefits in the elderly and infirm population.