MacFee incision: a safe approach to the neck

We reviewed 37 neck dissections done via the MacFee or double horizontal cervical incision to excise neoplasms located in the oral cavity and oropharynx, with draining cervical lymph nodes. One half of the patients had immediate reconstruction with myocutaneous flaps. Approximately 70% of the patients had advanced tumors and many were malnourished at presentation. Three wound complications involving the MacFee incision occurred in patients who were malnourished and required reconstruction. These wound complications were corrected with conservative therapy. Preoperative radiotherapy was a morbid cofactor. None of the patients had carotid artery involvement, wound dehiscence, or deep cervical infections. The MacFee incision can be used in major head and neck resections, with operative morbidity comparable to that of other techniques.