During the past 10 years, there have been extensive developments in both ldquo;islandrdquo; muscle and musculocutaneous flaps and in ldquo;freerdquo; microvascular transfers. Competition still exists between these two schools of surgical methodology, even though both methods are known to be complementary and have comparable success rates. Each individual procedure has its commending features, and the reconstructive surgeon should be conversant with both techniques to plan the best reconstruction for each patient. It is therefore important first to place each local flap into context with other local flaps, so that comparisons can then be made with the several free microvascular flaps that are available.
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