Anaesthetic Considerations in Free Flap Surgical Procedures

Abstract

Free flap surgery, a cornerstone of reconstructive microsurgery, addresses complex tissue defects from trauma, cancer, chronic wounds, infections, congenital anomalies, radiation damage, vascular insufficiency, and functional loss. This article explores anaesthetic management, perfusion optimization, postoperative care, critical to optimizing outcomes, focusing on preoperative optimization, intraoperative management, and postoperative care. Key physiological principles, including Hagen-Poiseuille and oxygen delivery equations, guide perfusion and oxygen delivery. Strategies such as multidisciplinary approach, goal-directed fluid therapy, normothermia, and judicious vasopressor use mitigate flap failure prevention risks (1-5%). Advances in techniques like total intravenous anaesthesia and monitoring technologies underscore the evolving nature of anaesthetic care in this field.

Keywords: Free flap surgery, reconstructive microsurgery, anaesthetic management, perfusion optimization, various flap types