Unsurpassed Reliability of Free Flaps for Head and Neck Reconstruction

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Abstract
DURING the decade after its description by Ariyan1 and Baek et al2 in 1979, the pectoralis major myocutaneous flap was widely considered to be the standard flap for reconstruction of major defects in the head and neck regions. Although the first microscope-assisted transfer of a free flap was reported in 1973,3 until recently there has been limited enthusiasm in the United States for applying free flaps for reconstruction of head and neck defects.4 This reluctance arose from several perceived potential shortcomings of microvascular tissue transfer. Such concerns included questions regarding the reliability of a technique that was dependent on small-vessel vascular anastomoses for a successful outcome and the potential for an adverse impact on the costs and complications of therapy. The current study was undertaken to document the reliability and safety of free flaps for reconstruction of defects in the head and neck.