Post-operative flap monitoring requires intensive care and experienced nursing to identify signs of flap failure or vascular compromise. This may require additional trips to the operating room for anastamosis revision to restore blood flow to the flap. However, the surgeon must also include the patient's attitudes, expectations and social status in the selection of reconstructive technique. A pectoralis major axial pattern flap used to fill a shoulder or upper arm defect may be effective and reliable, but it may further debilitate the function of the extremity in a thirty year old construction worker. The 90 year old non-ambulatory patient with a sacral decubitus ulcer may suffice with a skin graft that is quick and effective in providing a healed wound.
Operative time is minimal leading to less anesthesia time and blood loss.
Donor site morbidity would be limited. In this case, an axial or large random pattern flap involves a more sophisticated technique, but the patient should expect a more acceptable result in the long run. Reconstructive principles continue to evolve and some techniques are still in their infancy. Surgeons must determine the ideal method for each scenario. Presently, this involves the transfer of tissue from one part of the body to reconstruct another with the goal of over-all improvement.