Table 1. Comparison of commonly used free flaps for mangled upper extremities.
| Free flap | Pedicle | Flap size | FFMT | Intraop position change | Can be part of chimeric flap? | Primary debulking |
|---|---|---|---|---|---|---|
| Muscle-only/Myocutaneous | ||||||
| Rectus abdominis | DIEA | + + | No | No | No | No; atrophies later from denervation |
| Latissimus dorsi | TDA | + + + | Yes | Yes | Yes | |
| Gracilis | MCFA | + + | Yes | No | Yes | |
| Serratus anterior | Branch of TDA | + | Yes | Yes | Yes | |
| Fasciocutaneous | ||||||
| ALT | LCFA | + + | N/A | No | Yes | Yes; often requires further revision |
| SIEA/DIEP | SIEA/DIEP | + + | N/A | No | No | |
| TAP | TDA | + + + | N/A | Yes | Yes | |
| Radial forearm | Radial artery | + | N/A | No | Yes | |
| Lateral arm | PRCA | + | N/A | No | Yes | |
| Fascial | ||||||
| ALT | LCFA | + + | N/A | No | Yes | N/A |
| Dorsal thoracic | CSA | + + + | N/A | Yes | Yes | N/A |
| Temporoparietal | STA | + | N/A | No | No | N/A |
| Lateral arm | PRCA | + | N/A | No | Yes | N/A |
Abbreviations: ALT, anterolateral thigh; CSA, circumflex scapular artery; DIEA, deep inferior epigastric artery; FFMT, free functioning muscle transfer; LCFA, lateral circumflex femoral artery; MCFA, medial circumflex femoral artery; PRCA, posterior radial collateral artery; SIEA, superficial inferior epigastric artery; STA, superficial temporal artery; TAP, thoracodorsal artery perforator; TDA, thoracodorsal artery.