Emergency free flaps

The use of top-quality tissue in covering soft-tissue loss, and precocity in reconstructing injuries and restoring function, are major prerequisites for obtaining a good surgical result. Earlier methods of reconstruction, based on a delay, for various periods of time, in reconstruction, have gradually become obsolete. The employment of more aggressive techniques and research supporting the "as-early-as possible" morphological and functional reconstruction path has become the rule in dealing with emergency reconstructive interventions. This path has been opened by data that describe and clarify the reaction of skin, muscles, and osteo-articular vascular anatomy to traumatic injury. This research, combined with the current availability of a great number of both simple and complex free flaps, has spurred the development of the concept of the "emergency free flap." Here, the authors present a new classification of emergency free flaps, based on their experience using these procedures to treat traumatic injury. (C) 2003 Wiley-Liss, Inc.