During the last two decades the development of microvascular free-tissue transfer has provided a standard of care for reconstructing head and neck defects. Success rates vary from 94-99% and are dependent on the patency of vessels within the vascular pedicle.12 There have been reports of flaps surviving following division of the vascular pedicle. It is not known how long the flow in the pedicle must persist for the flap to survive and to develop an independent blood supply. The range found was from as little as three days up to three weeks.34 We present a case involving a free radial forearm flap for reconstruction of a buccal mucosa defect, with the flap surviving despite the loss of its arterial pedicle on the 12th postoperative day.
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