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Microsurgical workhorse flaps in head and neck reconstruction
1Department of Plastic Surgery, Head & Neck Oncology Center, University Hospital Orebro, Orebro, Sweden.
Clinics in Plastic Surgery
|June 28, 2005
Summary
For head and neck tumor reconstruction, three versatile flaps—anterolateral thigh, radial forearm, and fibula—offer excellent functional and esthetic outcomes with minimal donor site issues. Focusing on these workhorse flaps simplifies reconstruction and improves results.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Microsurgery
Background:
- Head and neck tumor resection often necessitates complex reconstruction.
- Numerous reconstructive flaps exist, but mastery can be challenging for surgeons.
- Achieving functional and esthetic restoration with minimal donor site morbidity is paramount.
Purpose of the Study:
- To identify and recommend the most effective and versatile "workhorse" flaps for head and neck reconstruction.
- To advocate for a focused approach to flap selection in reconstructive microsurgery.
Main Methods:
- Review of clinical experience with various reconstructive flaps over several years.
- Identification of anterolateral thigh flap (cutaneous or myocutaneous), radial forearm flap, and osteoseptocutaneous fibula flap based on utility and outcomes.
Main Results:
- These three selected flaps (anterolateral thigh, radial forearm, fibula) can address nearly all head and neck defects, individually or combined.
- Flap harvest is straightforward, with adequate pedicle length and caliber.
- Donor site morbidity associated with these flaps is negligible.
Conclusions:
- The anterolateral thigh, radial forearm, and fibula flaps are highly recommended as primary reconstructive options for head and neck defects.
- Surgeons should prioritize mastering these "workhorse" flaps over learning numerous other techniques.
- A focused approach enhances surgical efficiency and patient outcomes in head and neck reconstruction.