The Clinical Study on the Most Common Donor Sites in Head and Neck Reconstruction using Free Flaps

Lee, Seok Joon; Minn, Kyung Won

Abstract

The technique of microvascular surgery and understanding of regional vascular anatomy permitted the surgeon to utilize a greater variety of free flaps for reconstruction. Especially, head and neck is the most common defect site for which free flaps have been applied, because trauma and tumor happen frequently and head and neck reconstruction needs a variety of tissues, such as muscle, tendon, nerve and bone. In a 10-year period, 74 free flaps were performed for head and neck reconstruction following major head and neck ablative surgery. Transverse rectus abdominis musculocutaneous flap(TRAM), radial forearm fasciocutaneous flap and latissimus dorsi(LD) free flap were applied to 16 cases, 16 cases and 12 cases of head and neck reconstruction, respectively. As the most common donor sites in head and neck reconstruction, the greatest use of these flaps has been in midface defects including skull base and orbital area and scalp defects including skull defects. The role of these flaps is mostly to fill large defects with skin and fatty tissue, muscle and to protect the principal organ from external trauma and infection. In addition to these donor sites, a variety of donor sites can be used for reconstruction. Before the choice of donor site, the surgeon must not only exam patients underlying condition, but also consider all sides of a donor site; volume, thickness and texture of donor flap, operative and postoperative patients position, the postoperative change of transferred flap and donor morbidity and so forth.