Background and objectives: Microvascular free flap transfer has a crucial role in head and neck reconstructive surgery. This is a complex region due to the complexity of the anatomy and the function that plays, which also frequently requires large areas must be removed. The objective of this study is to identify potential factors directly related with the complication rate and survival of the free flap.

Methods: We have made a retrospective review of 100 patients that required a microvascular free flap transfer due to a benign or malign tumour, traumatic sequelae or osteoradionecrosis. The most relevant factors in this study were: pre-operative radiotherapy, TNM score, ASA score, type of free flap, type of microsuture, complications rate, location and the antiplatelet therapy post-surgery.

Results: 35.6% were performed with radial free flap, 22.9% anterolateral thigh flap, 19.5% osteocutaneous fibula flap, 14.9% fibula bone flap, 4.5% DCIA flap and 2.2% sural flap. Flap survival rate was scored with all the mentioned parameters.

Conclusions: The survival of the total of the flaps was 93%, while the complication rate was significantly related to the location of the reconstruction and type of flap.

Key words: free flap transfer; microvascular surgery