Free Flaps in Head and Neck Reconstruction

Introduction: The head and neck region’s defects presents a great challenge for reconstructive surgeons.

We report our experience in the treatment of 54 patients with head and neck free flap reconstruction (15 tumor resection, 2 with burns, one with postburned neck’s contracture, and 36 wounded patients).

Methodology and Material: We applied six fibular, four scapular, three radial forearm, one dorsalis pedis and one latissimus dorsi free flaps. Fibular and radial forearm flaps were used for reconstruction of the mandibular bone, while scapular, dorsalis pedis and latissimus dorsi flaps were used for filling the defects of the mouth floor, orbital or maxilar region. We used scapular free flaps for covering the burn of the face, scapular and parascapular flaps for the covering of the neck and exposed mandibular bone and preexpanded scapular and parascapular flap for correction of the neck’s postburn contracture.

Results: We treated extensive wartime tissue defects of the lower third of the face with composite free flaps: seven scapular, nine radial forearm and twenty fibular flaps. Length of the mandibular defects varied from 5-16 cm. The bones were fixed by wire, miniplates or external fixation. The skin parts of the flaps were used in reconstruction of lower lip, chin and/or cheek, respectively. Vascular pedicles of the flaps were microsutured to either the superior thyroid, facial or external maxillary and carotid vessels.

Conclusions: Our experience and results in microvascular reconstruction in the head and neck region support the use of this reconstructive method