CPT® Code 20970

A free osteocutaneous flap is a surgical procedure utilized to repair complex defects involving both soft tissue and bone. This technique is particularly beneficial in cases where there is a significant loss of tissue due to trauma, disease, or surgical resection. The procedure involves the transfer of a flap that includes skin, subcutaneous tissue, and bone, all of which are harvested from a donor site, in this case, the iliac crest. The iliac crest is chosen for its ample supply of bone and soft tissue, making it an ideal site for reconstruction. The process begins with careful measurement of the defect to determine the appropriate size of the flap. Surgeons meticulously plan the incision lines on the skin of the donor site, ensuring that the vascular pedicle, which supplies blood to the flap, is preserved during dissection. Once the flap is harvested, it is transferred to the recipient site where it is secured in place, and the vascular connections are established using microvascular techniques. This intricate procedure not only restores the structural integrity of the affected area but also enhances the aesthetic appearance by providing a viable tissue cover.