Folded, bipaddled composite flap in head and neck reconstruction

A series of 34 patients repaired by folded, bipaddled composite flaps for head and neck cancer surgical defects is presented. Pectoralis major composite flap was used in 33 patients on musculovascular pedicle and 1 patient had a latissimus dorsi composite flap free-tissue transfer. The pectoralis major rib, osteomyocutaneous flap was utilized in 6 patients who had lesions of the mouth floor and anterior mandibular arch. The incorporated rib was used as a vascularized bone graft for the stability of mandibular fragments. Thus, one regional composite flap used in bipaddled fashion enabled the reconstruction of mucosal, skin, and mandibular arch defects.