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[Free functional muscle transplantation with microneurovascular anastomosis: development of a standardized surgical procedure].

Although investigated experimentally almost at the same time, free muscle transplantation without microvascular anastomoses was accepted as a clinical method earlier than muscle transplantation with microneurovascular anastomoses, which finally proved to be the method with better functional results in the late seventies. Our experimental investigations of different factors such as anoxemia, reinnervation, initial muscle tension, and of the functional capacity of this kind of muscle graft and of the time course of the alterations in the microsurgically vascularized muscle transplants influenced the operative concept for clinical application to a great extent. Besides general details of the operative technique, specific considerations with respect to the two main regions of clinical application namely the face and the extremities are presented.