J Reconstr Microsurg 2009; 25(3): 191-195
DOI: 10.1055/s-0028-1103508
© Thieme Medical Publishers

Reconstruction of Head and Neck Cancer with Double Flaps: Comparison of Single and Double Recipient Vessels

Pao-Yuan Lin1 , Yur-Ren Kuo1 , Chih-Yen Chien2 , Seng-Feng Jeng1
  • 1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
  • 2Department of Otolaryngology, Chang Gung Memorial Hospital – Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsien, Taiwan
Further Information

Publication History

Publication Date:
11 December 2008 (online)

ABSTRACT

Patients with advanced head and neck cancers require reconstruction with a double free flap, but in some situations, it is extremely difficult to attain the ideal set of recipient vessels for these patients. The patients were divided into two groups: group 1 had one recipient vessel; group 2 had two recipient vessels. Fifty-five patients were enrolled between 2001 and 2005. Double flaps, including a fibula osteoseptocutaneous flap and an anterolateral thigh flap, were used for the reconstruction. In group 1, the second flap was anastomosed at the distal runoff of the fibular flap. Group 1 contained 39 patients and group 2 had 16 patients. No significant differences in the success rate, operating time, days of hospitalization, or complication rate were noted between groups 1 and 2. Thus using one recipient vessel is our first choice for double free-flap reconstruction for head and neck defects.

REFERENCES

  • 1 Yazar S, Wei F C. Selection of recipient vessels in double free-flap reconstruction of composite head and neck defects.  Plast Reconstr Surg. 2005;  115 1553-1561
  • 2 Koshima I, Hosoda S. Free combined anterolateral thigh flap and vascularized fibula for wide, through-and-through oromandibular defects.  J Reconstr Microsurg. 1998;  14 529-534
  • 3 Ozakan O, Coskunfirat O K, Ozgentas H E, Dikici M B. New experimental flap model in the rat: free flow-through epigastric flap.  Microsurgery. 2004;  24 454-458
  • 4 Wells M D, Luce E A. Sequentially linked free flaps in head and neck reconstruction.  Clin Plast Surg. 1994;  21 59-67
  • 5 Sanger J R, Matloub H S. Sequential connection of flaps: a logical approach to customized mandibular reconstruction.  Am J Surg. 1990;  160 402-404
  • 6 Ceulemans P. Flow-through anterolateral thigh flap for a free osteocutaneous fibula flap in secondary composite mandibular reconstruction.  Br J Plast Surg. 2004;  57 358-361
  • 7 David D J, Tan E, Katsaros J, Sheen R. Mandibular reconstruction with vascularized iliac crest: a 10-year experience.  Plast Reconstr Surg. 1988;  82 792-803
  • 8 Wei F C, Demirkan F, Chen H C. Management of secondary soft-tissue deficits following microsurgical head and neck reconstruction by means of another free flap.  Plast Reconstr Surg. 1999;  103 1158-1166
  • 9 Wei F C, Demirkan F, Chen H C. Double free flaps in reconstruction of extensive composite mandibular defects in head and neck cancer.  Plast Reconstr Surg. 1999;  103 39-47
  • 10 Koshima I, Hosoda M, Moriguchi T. A combined anterolateral thigh flap, anteromedial thigh flap, and vascularized iliac bone graft for a full-thickness defect of the mental region.  Ann Plast Surg. 1993;  31 175-180
  • 11 Wei F C, Celik N, Chen H C. Combined anterolateral thigh flap and vascularized fibula osteoseptocutaneous flap in reconstruction of extensive composite mandibular defects.  Plast Reconstr Surg. 2002;  109 45-52
  • 12 Amin A AW, Baldwin B J, Gurlek A. Second free flaps in head and neck reconstruction.  J Reconstr Microsurg. 1998;  14 365-369
  • 13 Chen H C, Tang Y B. Anterolateral thigh flap: an ideal soft tissue flap.  Clin Plast Surg. 2003;  30 383-401
  • 14 Soutar D S, Scheker L R, Tanner N S, McGregor I A. The radial forearm flap: a versatile method for intra-oral reconstruction.  Br J Plast Surg. 1983;  36 1-8
  • 15 Lorenzetti F, Suominen S, Tukininen E. Evaluation of blood flow in free microvascular flap.  J Reconstr Microsurg. 2001;  17 163-167

Dr. Seng-Feng JengM.D. 

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital – Kaohsiung Medical Center

123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan

Email: lin.a0708@msa.hinet.net

    >