Purpose: Microsurgical reconstruction of head and neck tumor defects has become the standard approach at university medical centers. We review the head and neck tumor reconstruction experience utilizing free tissue transfer of a private practice plastic surgeon. These results were compared to academic studies to demonstrate free tissue transfer can be efficiently performed in a non university medical center.

Methods: 143 patients’ charts from 1993-2002 were retrospectively reviewed. Demographics, operative time, complications, and recurrence rates were obtained. Chi square and Fisher exact test were used when appropriate.

Results: 160 flaps were performed on 143 patients ages ranging from 3 to 92. Floor of mouth was the most common site of tumor although a variety of defect sites and tumor types were encountered. 96% flap success rate and 4% (6) flap failures were noted. Nine of 14 flaps that had an ischemic event were salvaged for a salvage rate of 57%. The average operative time for the tumor extirpation and reconstruction was 5 hours 49 minutes. 2 perioperative deaths occurred.

Conclusions: Head and neck free tissue reconstruction does not have to be limited to academic medical centers. Free tissue construction can be efficiently and successfully performed in a non academic setting.