{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:06:26Z","timestamp":1790251586971,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microvascular free flap surgery is a cornerstone of modern reconstructive surgery, providing robust coverage for complex defects. While studies have examined outcomes in specific anatomical sites, few have evaluated long\u2010term institutional trends across all indications. This study aimed to assess temporal changes in microvascular free flap reconstructive surgery at a tertiary plastic surgery unit over 12\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted of free and locoregional flap reconstructions performed between 2012 and 2023 at a single tertiary centre. Data collected included patient demographics, flap type, anatomical region, surgical indication and complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 912 free flaps and 628 locoregional flaps were performed during the study period. The volume of free flaps increased by 2.6\u2010fold, from 4.7 procedures per month in 2012 to 12.2 in 2023 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), whereas locoregional flap rates remained stable. Head and neck reconstruction accounted for the majority of cases (58%), followed by lower limb (29%) and breast (6.3%), with breast and lower limb demonstrating the greatest proportional growth. Malignancy was the most frequent indication, although trauma and infection\u2010related reconstructions increased in later years. Takeback rates declined from 25.6% in 2012 to 17.1% in 2023, with flap loss rates consistently below 5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This 12\u2010year review demonstrates a significant rise in free tissue reconstructions without a corresponding decline in locoregional procedures, indicating a genuine growth in microsurgical activity. These findings highlight increasing demand, improved outcomes, and the ongoing need for investment in microsurgical services, training, and infrastructure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70754","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T09:14:41Z","timestamp":1779873281000},"page":"2409-2415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in Microvascular Free Flap Reconstruction at a Single Tertiary Centre: A 12\u2010Year Retrospective Review"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-3556","authenticated-orcid":false,"given":"Lachlan","family":"Yaksich","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandria Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lachlan","family":"McMillan","sequence":"additional","affiliation":[{"name":"Sunshine Coast University Hospital  Sunshine Coast Australia"},{"name":"Department of Medicine Griffith University  Sunshine Coast Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2486-7911","authenticated-orcid":false,"given":"Amy","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandria Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wagels","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandria Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Theile","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandria Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1973.tb05659.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.70032"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18798"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003927"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10006-020-00838-7"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2024.02.058"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1357272"},{"key":"e_1_2_11_9_1","volume-title":"Population Growth Highlights and Trends, Queensland Regions, 2022 Edition","author":"Queensland Government Statistician's Office","year":"2022"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"E132","article-title":"Anterolateral Thigh Versus Pectoralis Major Flaps in Reconstruction of the Lateral Temporal Bone Defect","volume":"89","author":"Parr J. M.","year":"2018","journal-title":"ANZ Journal of Surgery"},{"key":"e_1_2_11_11_1","volume-title":"Head and Neck Cancer in Australia Statistics","year":"2022"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2024.05.002"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2020.09.012"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2019.00157"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198609000-00001"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.82B7.0820959"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.05.017"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orthop.2020.12.003"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2025.03.003"},{"key":"e_1_2_11_20_1","volume-title":"Queensland Road Crash Weekly Report","author":"Department of Transport and Main Roads","year":"2024"},{"key":"e_1_2_11_21_1","volume-title":"Road Trauma\u2010Related Hospitalisations in Queensland Public Acute Hospitals: 01 Jan 2019 to 31 Dec 2023","author":"Banu S.","year":"2024"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002664"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002324"},{"issue":"2","key":"e_1_2_11_24_1","first-page":"170","article-title":"An Institutional Analysis of Early Postoperative Free Tissue Transfer Takeback Procedures","volume":"41","author":"Alvarez A. H.","year":"2024","journal-title":"Journal of Reconstructive Microsurgery"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2025.07.015"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70754","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70754","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:16:53Z","timestamp":1790248613000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/ans.70754"],"URL":"https:\/\/doi.org\/10.1111\/ans.70754","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}