Free and pedicled flaps for head and neck reconstruction in radically irradiated fields: 6 years' experience at the...

From 1982 to 1988, 127 flaps were performed after ablative surgery for head and neck squamous cell carcinoma: 86 pedicled pectoralis major island and 41 free flaps of different types. One hundred and four were evaluable for this retrospective study: 66 after definitive radiotherapy (6000-8000 cGy) and surgery for recurrent or persistent disease and 38 after elective surgery for Stage III and IV tumors without previous irradiation. Wound healing, hospital stay, survival rate and complications are compared between irradiated and nonirradiated areas. The indications, advantages and disadvantages of each type of flap are reviewed according to the main goals of our treatment: i.e. local disease control, restoration of function, cosmetic appearance and short hospital stay.