Some defects are too large or too complex to close with nearby skin. In microvascular reconstruction, the surgeon moves a section of tissue, which may include skin, fat, muscle or bone, from one part of the body to another and reconnects its artery and vein under an operating microscope. This is known as a free flap.

At Apex, the team plans which tissue to use, how to provide the best function and how to limit what is taken from the donor area. Typical situations include a limb injury with exposed bone, a defect in the head or neck after cancer surgery or tissue loss after infection. The operation is long and precise, and the blood supply of the new tissue is checked closely in the first days.

A flap depends on tiny vessels staying open, so in a small number of cases a patient has to return to theatre if blood flow is threatened. Other risks include infection, wound separation, donor site pain and flap loss. Smoking, diabetes and poor circulation raise the risk, and the team discusses this beforehand.

Apex provides microvascular reconstruction for trauma and cancer defects:

• Free Flap Reconstruction: Apex performs free flap transfer with microsurgical vessel repair.
• Pedicled Flap Reconstruction: Apex performs pedicled flaps that bring tissue on its own blood supply.
• Post-Trauma Reconstruction: Apex reconstructs limb and soft tissue defects after injury.
• Post-Oncological Reconstruction: Apex reconstructs defects left after tumour removal.