Anaesthesia for Microvascular Surgery & Free Tissue Transfer - Understanding free tissue flaps

Wound management is a mostly straight-forward task. Some wounds, however, present unique challenges because of their size, shape, position or underlying structures. Where simple closures or skin grafting is not possible, the ability to transfer viable cutaneous tissue from one area to another has allowed people to overcome major wounds, reduce hospital stays, and return to a functional existence. Plastic surgeons have developed a number of techniques to move flaps of tissue, achieving both closure of wounds and aesthetic reconstruction of tissues.

This is a 3 part series of presentations focusing on anaesthesia for microvascular surgery, and in particular, the microvascular surgery required for free tissue flap transfers. In part 1 Dr Ian Hogarth aims to explain some of the flap types available to our plastic surgery colleagues, and their uses in wound management. The presentation will look at the physiology of the flap, and consider the implications of surgery for both the patient and the tissue flap.

Learning outcomes:

1. Outline the role and types of tissue flap surgery in wound management.
2. Consider the physiology and surgical implications of flap surgery, and the management of anaesthesia to facilitate outcomes.
3. Review the use of vasoactive and anticoagulant drugs in both the intra- and post-operative period.