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ASA IV status was weakly associated with surgical complications (OR 3.89, P=0.053), but CCI and elderly age were not associated with any outcome. Median length of stay was similar between age groups. Free-flap reconstruction in older patients was associated with increased medical complications, and surgical complications were weakly associated with ASA status. Advanced age or comorbidity should not preclude microvascular reconstruction, but comorbid status should be optimized pre-operatively and factors predisposing to medical complic