Background and ObjectivesIn a rural‐based setting, providing optimal treatment is often difficult owing to the limited resources and financial constraints being rampant in cancer care delivery. Oncological resections often result in large, complex defects requiring free flap reconstruction to achieve cosmetic and/or functional goals. This article focuses on our experience of starting and promoting microvascular reconstruction in a rural tertiary medical college hospital.MethodsRetrospective observational study of patients undergoing free flap reconstruction for oncological indications was included. Standard oncological principles were followed for cancer extirpation. Free flap reconstruction was done using loupes of 4× magnification. Flap‐related outcomes and barriers in doing free flap reconstruction were analysed.ResultsA total of 56 patients were included. The most common free flap undertaken was free anterolateral thigh flap in 21 (37.5%) patients. The mean duration of reconstruction was 438 min. Re‐exploration was undertaken in 17 patients (30.4%). Nonsalvageable flap loss was 19.64%. Adjuvant treatment was administered in all patients as per oncological indications, albeit with some delay in 12.5%. Barriers to reconstruction were noted in the pre‐, intra‐ and postoperative periods.ConclusionReconstruction with free flaps is feasible in a resource‐constrained setup with careful planning and a multidisciplinary team approach to overcome the barriers.

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农村三级医学院免费皮瓣重建：障碍和结果

背景和目标在农村环境中，由于资源有限且癌症护理服务中普遍存在财务限制，提供最佳治疗通常很困难。肿瘤切除通常会导致大而复杂的缺损，需要游离皮瓣重建以实现美容和/或功能目标。本文重点介绍我国某乡村三级医院开展和推广微血管重建的经验。方法对因肿瘤适应症行游离皮瓣重建的患者进行回顾性观察研究。癌症根除遵循标准肿瘤学原则。使用放大倍数为 4 倍的放大镜进行游离皮瓣重建。分析了皮瓣相关的结果和进行游离皮瓣重建的障碍。结果共纳入 56 名患者。最常见的游离皮瓣是游离大腿前外侧皮瓣，有 21 名患者（37.5%）。重建的平均持续时间为 438 分钟。17 名患者（30.4%）进行了重新探查。不可挽救的皮瓣损失率为19.64%。尽管有 12.5% 的患者出现延迟，但所有患者均根据肿瘤学指征进行了辅助治疗。在术前、术中和术后期间都注意到了重建的障碍。结论在资源有限的情况下，通过仔细的规划和多学​​科团队的方法来克服障碍，使用游离皮瓣进行重建是可行的。