[Second reconstructions after failure of free-tissue transfer in the head and neck region]

A retrospective study was performed on 74 patients seen in our hospital between 1990 and 1999 who underwent head and neck reconstructive surgery involving a free flap. Reconstructive surgery was unsuccessful in 5 cases (6.8%). A pedicled myocutaneus flap was used in two cases for the second reconstruction attempt, while a second free flap (jejunum) was used in two other patients. In these cases, a bilateral neck dissection was performed prior to the second free flap reconstruction and neck infection was found. The head and neck artery and vein were unsuitable as recipient vessels in the second operation. Instead, the cephalic vein was used as a source of vein grafts and as a recipient vein.