Microvascular free flap reconstruction: the challenges in the developing country

Abstract

After years of development, microvascular free tissue transfer has been firmly established as the primary method for reconstrutive surgery. The concept of using a reconstructive ladder to repair complex defects has been revolutionized and the tradition of using free flap surgery as the last resort has been challenged. In a developing country like ours, surgeons are still contending with the basic problems of microvascular free tissue transplantation.


An 18-year old student presented to our hospital with a diagnosis of osteomyelitis of the frontal bone. A radical debridement of osteomyelitic bone was done and the defect created was repaired with a microvascular free lattisimus dorsi musculocutaneous flap. The procedure lasted about 16 hours with a long duration of warm ischaemic time, but the flap survived. Institutional support is highly necessary for making available appropriate microvascular instruments, operating microscope, pharmacologic agents, allocation of operative time and post operative care, if we must make progress in the field of microvascular surgery in the West African sub-region.


KEY WORDS: Microvascular Free Flap, Challenges, Developing Country


Sahel Medical Journal Vol.7(2) 2004: 73-75