https://he02.tci-thaijo.org/index.php/agstjournal <div id="model-response-message-contentr_a1456f9b74bb4a25" class="markdown markdown-main-panel stronger enable-updated-hr-color" dir="ltr" aria-live="polite" aria-busy="false"> <p data-path-to-node="1">The Journal of the Association of General Surgeons aims to promote the academic role in surgery at both national and international levels, while fostering collaborative network relationships both within and outside the association. It seeks to create academic works and disseminate them to all sectors, developing its function in alignment with the vision and mission focused on ensuring Thai surgeons achieve academic excellence in surgery at the international level.</p> <p data-path-to-node="2">The Journal seeks to ensure that research findings and academic articles are disseminated to the general public, building capacity for presenting scholarly work, research, and surgical knowledge to professional groups. It serves as a national center for the transfer and exchange of medical knowledge and technology, in accordance with the country's strategic plan.</p> <p data-path-to-node="3">Furthermore, it offers opportunities for surgeons, academics, and the general public, both inside and outside the association, to submit their own scholarly works, articles, and research. This promotes and develops academic knowledge in seeking evidence-based practice to support professional work, enhances the capacity for presenting scholarly work and research, and disseminates surgical knowledge to allied professional groups, thereby establishing the Journal as the central platform for publishing and publicly disseminating academic articles.</p> </div> สมาคมศัลยแพทย์ทั่วไปแห่งประเทศไทยในพระบรมราชูปถัมภ์ en-US Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 1686-879X https://he02.tci-thaijo.org/index.php/agstjournal/article/view/278988 <p><em>Background</em>: Free tissue transfer (FTT) has become the preferred method in modern reconstructive surgery, offering excellent functional and aesthetic outcomes, particularly for complex oncologic, traumatic, and post-infectious defects. This study describes the early experience and key lessons learned from a series of FTT procedures performed by a novice plastic surgeon at Nakhon Phanom Hospital, a standard-level (S-level) hospitals in Thailand.</p> <p><em>Methods</em>: Medical records of all patients who underwent FTT performed by a single surgeon were reviewed. Data collected included demographics, operative details, pathology results, and postoperative complications.</p> <p><em>Results</em>: Nineteen FTT procedures were identified, performed for reconstruction of the head and neck (n = 15) and lower extremities (n = 4). Five cases experienced postoperative complications resulting in flap compromise. Three of eight threatened flaps were successfully salvaged. The primary causes of flap loss were vascular complications, including venous congestion (26.3%) and arterial thrombosis (15.7%). The overall flap success rate was 73.7%.</p> <p><em>Conclusions</em>: Performing free tissue transfer as a novice plastic surgeon in a non-academic hospital with no prior experience in this procedure posed significant challenges. Limited early postoperative monitoring capacity, insufficiently trained nursing staff, and the surgeon’s learning curve contributed to delays in critical decision-making. Ultimately, improving outcomes in such settings requires recognizing systemic limitations, implementing continuous team training, and maintaining perseverance throughout the demanding early learning phase.</p> Sarinya Boonpoapichart Natthawoot Hongkarnjanakul Copyright (c) 2026 Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 2026-03-01 2026-03-01 11 1 1 13