Abstract
Merits and demerits of free tissue transfer with microvascular anastomosis for large head and neck defects in the elderly are discussed as compared with the standard pedicled flaps. Results of consecutive 190 flap transfers revealed that, in the elderly, 1) large flap transfers can safely be applied as in younger generations, 2) no definitive limitation is present in indicating various kinds of free tissue transfers, 3) the free rectus abdominis flap and the jejunal segment are the recommended free grafts, 4) as to pedicled flaps delto-pectoral flap is recommended while pectoralis major flap having danger of local complications, 5) the real risk factor is the general complication namely diabetes mellitus and liver cirrhosis.
