[Microsurgical reconstruction of large 3-layer defects of the cheek]

For reconstruction of large penetrating defects of the cheek besides pedicled tissue transfer numerous free flaps are available to the head and neck surgeon. The inferior epigastric abdominal wall flap, in particular, has proved a versatile and reliable flap, just as the cutaneous flaps from the dorsum of the foot and from the forearm. While the abdominal wall flap offers both, a cutaneous and a peritoneal surface, the latter is used for replacement of intra-oral lining, the cutaneous flaps have to be folded to obtain two surfaces for reconstruction of skin and intra-oral lining. The surgical technique of the epigastric abdominal wall flap is presented and its use is discussed.