Folded, bipaddled composite flap in head and neck reconstruction

Area of Science:

• Reconstructive Surgery
• Head and Neck Oncology
• Composite Flap Techniques

Background:

• Head and neck cancers often result in complex surgical defects requiring extensive reconstruction.
• Traditional methods may not always provide adequate tissue volume or vascularity for optimal defect closure.
• Composite flaps offer a promising solution by combining multiple tissue types for versatile reconstruction.

Purpose of the Study:

• To evaluate the efficacy of folded, bipaddled composite flaps in reconstructing surgical defects from head and neck cancer.
• To assess the functional and aesthetic outcomes of using these flaps.
• To highlight the adaptability of regional composite flaps for complex defect repair.

Main Methods:

• A retrospective review of 34 patients undergoing reconstruction with folded, bipaddled composite flaps for head and neck cancer defects.
• The Pectoralis major composite flap was the primary method used (33 patients), with one latissimus dorsi free-tissue transfer.
• The pectoralis major rib osteomyocutaneous flap was specifically used in 6 patients with mandibular arch defects.

Main Results:

• Folded, bipaddled composite flaps successfully reconstructed mucosal, skin, and mandibular arch defects in all 34 patients.
• The pectoralis major flap provided robust tissue for defect closure.
• The pectoralis major rib osteomyocutaneous flap ensured stability of mandibular fragments through vascularized bone grafting.

Conclusions:

• Folded, bipaddled composite flaps are a reliable and effective method for reconstructing complex head and neck cancer surgical defects.
• This technique allows for simultaneous reconstruction of multiple tissue types, including bone, skin, and mucosa.
• Regional composite flaps, utilized in a bipaddled fashion, offer a versatile solution for challenging reconstructive scenarios.