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Updated: May 8, 2026
Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Microvascular free flap reconstruction for head and neck cancer in a resource-constrained environment in rural India
Nirav P Trivedi1, Pravin Trivedi, Harish Trivedi
1Department of Plastic Surgery, Trivedi Polyclinic and Nursing Home, Mehsana, Gujarat, India ; Department of Plastic Surgery, Mazumdar Shaw Cancer Center and NH, Bangalore, India.
Introduction:
Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialised procedure and is not routinely performed in the resource-constrained environment of certain developing parts of India.
Materials And Methods:
This article focuses on the practice environment in a cancer clinic in rural India. Availability of infrastructure, selection of the case, choice of flap, estimation of cost and complications associated with treatment are evaluated and the merits and demerits of such an approach are discussed.
Results:
We performed 22 cases of free flaps in a six-month period (2008-2009). Majority (17) of the patients had oral cancer. Seven were related to the tongue and eight to the buccal mucosa. Radial forearm free flap (RFF: 9) and anterolateral thigh flap (ALT: 9) were the most commonly used flaps. A fibula flap (1) was done for an anterior mandible defect, whereas a jejunum free flap (1) was done for a laryngopharyngectomy defect. There were six complications with two re-explorations but no loss of flaps.
Conclusion:
Reconstruction with microvascular free flaps is feasible in a resource-constrained setup with motivation and careful planning.