Omental free flap reconstruction in complex head and neck deformities

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Abstract
Background: Microvascular free flaps continue to revolutionize coverage options in head and neck reconstruction. This article reviews our 25‐year experience with omental free tissue transfers.Methods: All patients who underwent free omental transfer to the head and neck region were reviewed.Results: Fifty‐five patients were included with omental transfers to the scalp (25%), craniofacial (62%), and neck (13%) region. Indications were tumor resections, burn wound, hemifacial atrophy, trauma, and moyamoya disease. Average follow‐up was 3.1 years (range, 2 months–13 years). Donor site morbidities included abdominal wound infection, gastric outlet obstruction, and postoperative bleeding. Recipient site morbidities included partial flap loss in four patients (7%) total flap loss in two patients (3.6%), and three hematomas.Conclusions: The omental free flap has acceptable abdominal morbidity and provides sufficient soft tissue coverage with a 96.4% survival. The thickness \and versatility of omentum provide sufficient contour molding for craniofacial reconstruction. It is an attractive alternative for reconstruction of large scalp defects and badly irradiated tissue. © 2002 Wiley Periodicals, Inc. Head Neck 24: 326–331, 2002; DOI 10.1002/hed.10082