Free Vascularised Skin and Fat Transfer

Soft tissue deficiencies causing superficial depressions and deformities have posed difficult problems for reconstructive surgery. In the past, soft tissues like fat, true skin and fat, fascia and skin, etc, have been widely used to fill up concavities and correct deformities. Clinical experience showed that these methods of free transplant might not have good long term results. The common defects of these methods of transplant are: (1) The power to resist infection is extremely low. This is particularly so in the case of superficial transplants. Even for stitch infection, the transplanted substance might get infected and subsequently undergo necrosis and rejection. (2) Large grafts very often lead to central septic necrosis and liquidation. (3) Gradual absorption by the surrounding tissues occurs after transplant. Absorption is particularly obvious for free fat transplant, sometimes one-third to half of the fat transplanted may be absorbed. (4) Fibrosis of the transplanted tissues resulting in late deformities…