Though technically feasible, free tissue transfer carries the risk of perioperative morbidity and mortality in elderly patients.

To minimize the operative treatment time and complication rates, we choose the rectus abdominis muscle (RAM) flap.

Between 2012 and 2017, 34 patients (mean age: 74±7 years, range: 65–89 years) with comorbidities underwent defect reconstruction with a free RAM flap.

Recipient-sites were: lower extremity (65%), trunk (18%), upper extremity (12%), and head and neck (6%).