Microsurgical tissue transfer — moving living tissue from one part of the body to another with its own blood supply reattached — to reconstruct complex defects after cancer, trauma or radiation.
A free flap is a block of living tissue — skin, fat, muscle, bone or a combination — that is completely detached from the body with its arterial and venous pedicle, transferred to a recipient site and reconnected microsurgically. It enables reconstruction of large, complex tissue defects that no local tissue can cover — providing durable, well-vascularised coverage of exposed bone, joints or vital structures, and restoring form and function after cancer surgery or trauma.
Dr. Thusay collaborates with the treating oncologist or orthopaedic surgeon to plan the defect size, the optimal flap and the timing of reconstruction relative to other treatments.
Donor site chosen based on defect requirements: volume, skin quality, bone need, vessel pedicle length and donor site morbidity.
Two surgical teams work simultaneously — one preparing the recipient site and recipient vessels, one harvesting the flap. Microsurgical anastomosis performed under operating microscope.
Flap monitored clinically and with Doppler hourly. Any vascular compromise detected early allows emergency return to theatre for salvage.
Hospital stay 5–10 days. Rehabilitation coordinated with the primary treating team. Donor site heals over 2–4 weeks.
In experienced hands, free flap survival rates are consistently 95–98%. Dr. Thusay has performed over 1,000 microsurgical procedures. Strict patient selection, meticulous surgical technique and rigorous post-operative monitoring are the key to consistently high success rates.
Skin grafts require a well-vascularised, clean wound bed to survive. They cannot cover exposed bone, tendon, joint or implant — where a free flap is the only option. Free flaps also provide more tissue bulk and better long-term durability.
The donor site is carefully closed primarily wherever possible. For ALT and DIEP flaps, the scar is in a concealed location. For the fibula, leg function is fully preserved as 1 of 2 leg bones — the fibula is not a weight-bearing bone.
Typically 5–10 days, including 48–72 hours of intensive flap monitoring followed by wound care, mobilisation and rehabilitation.
Partial or complete flap loss requires management — debridement and alternative reconstruction. Early detection of vascular compromise (within 6 hours) allows emergency take-back to theatre and flap salvage in most cases. Dr. Thusay's post-operative monitoring protocols are designed for this.
Yes. International patients are assessed via video consultation and all pre-operative investigations coordinated. Surgery is planned with admission, and post-operative follow-up continues remotely after return.
Immediate reconstruction (done at the same time as the tumour resection) is preferred in most cases — it is oncologically safe and avoids a second general anaesthetic. Dr. Thusay coordinates closely with the surgical oncology team.
A perforator flap is a refinement of free flap surgery — tissue is harvested based on a single perforating blood vessel, sparing the underlying muscle entirely. This reduces donor site morbidity significantly. DIEP flap (no muscle taken) vs TRAM flap (muscle taken) is the classic example.
Dr. Pranav Thusay will personally assess your case and create a tailored plan.