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Multivariate logistic regression models were used to determine risk factors for unplanned reoperations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 2,244 MFTT cases. There were 290 associated unplanned reoperations (12.92%). There was a threefold increase in the rate of complications when patients underwent reoperation (58.28% vs 18.12%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Head and neck reconstructions had the highest rate of reoperations (18.04%). Most reoperations were debridements (38.28%), followed by microvascular procedures (28.97%) and flap revisions (26.55%). American Society of Anesthesiologist (ASA) classification \u22653 [OR 1.565, 95% CI (1.204, 2.034), <jats:italic>p<\/jats:italic>\u2009=\u20090.0008] and prolonged operative time [OR 1.597, 95% CI (1.221, 2.089), <jats:italic>p<\/jats:italic>\u2009=\u20090.0006] were significant independent risk factors for reoperations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Unplanned reoperations are a useful quality indicator for MFTT. ASA classification \u22653 and prolonged operative time were risk factors associated with an increased risk for unplanned reoperations. \u00a9 2015 Wiley Periodicals, Inc. 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