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Personalized Strategies for Head and Neck Reconstruction Using Pedicled Flaps
Giuseppe Riva1, Andrea Canale1, Gian Marco Motatto1
1Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy.
Journal of Personalized Medicine
|February 26, 2026
Summary
Pedicled flaps are a viable option for head and neck reconstruction when free flaps are not suitable. This study found that pedicled flaps, like the pectoralis major flap, have acceptable complication rates for selected patients.
Area of Science:
- Surgical reconstruction
- Head and Neck Surgery
- Plastic Surgery
Background:
- Free flaps are the standard for head and neck reconstruction.
- Contraindications for free flaps include advanced age and comorbidities.
- Pedicled flaps offer an alternative in specific patient populations.
Purpose of the Study:
- To evaluate head and neck reconstruction strategies using pedicled flaps.
- To analyze the complication rates associated with pedicled flap reconstruction.
- To assess the utility of pedicled flaps in the era of free flap surgery.
Main Methods:
- Observational study of patients undergoing head and neck reconstruction with pedicled flaps.
- Analysis included various flap types such as pectoralis major (PMF), deltopectoral, and facial artery myomucosal flap (FAMM).
- Systematic recording of patient characteristics, flap type, recipient sites, and flap-related complications.
Main Results:
- 112 pedicled flaps were analyzed, with PMF most common for tongue/hypopharyngeal reconstruction.
- Partial flap necrosis occurred in 11.6%, complete necrosis in 1.8%.
- Complications included wound dehiscence (12.5%), fistulas (6.3%), hemorrhage (3.6%), and stenosis (0.9%).
Conclusions:
- Reconstructive strategy selection is dependent on defect site and size.
- Pedicled flaps demonstrate low complication rates.
- Pedicled flaps remain a valid reconstructive choice for select head and neck patients.
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