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Free tissue transfer as a vascular source for the vessel-depleted neck
Chung-Kan Tsao1, Charles Yuen Yung Loh2, Joaquim Megias Barrera3
1Department of Plastic Surgery, Chang Gung Memorial Hospital, Taiwan, Peoples Republic of China. nightman251@hotmail.com.
Background:
Reconstructing head and neck defects postoncologic resection can be challenging. This problem is further amplified when tackling the vessel-depleted or hostile neck. Free flaps still provide the gold standard of reconstructing such defects. However, with increasing reconstructions, recipient vessel options rapidly diminish. This article provides a technique and strategy in managing such difficult cases using previous free flap pedicles. It also highlights the importance of flap selection in paving the way for future successful reconstructions.
Methods:
We present a fifth sequential free flap reconstruction postoncologic buccal resection and mention the key steps taken to ensure the safe and successful reuse of previous free flap pedicles.
Results:
Intraoperative and postoperative photographs are clearly presented with a particular focus on the management of the recipient pedicle.
Conclusion:
Adequate planning and strategic selection of free flaps with long pedicles can provide the necessary vascular sources needed for future successful free flap head and neck reconstructions. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2515-E2518, 2016.
