Microsurgical free flap in head and neck reconstruction

Chin Ho Wong, Fu Chan Wei*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

254 Scopus citations


Microsurgical free flaps are today considered state of the art in head and neck reconstruction after composite tumor resections. Free flaps provide superior functional and aesthetic restoration with less donor-site morbidity. This article details our approach to this challenging and complex procedure. Free tissue transfer can be viewed as consisting of 4 essential stages: (1) defect assessment, (2) preparation of recipient vessels, (3) flap selection and harvest, and (4) flap inset and microsurgical anastomoses. The essential details of each step are highlighted. Meticulous attention to each step is important because each plays a crucial role in the overall success of the procedure. Workhorse flaps in our practice are the anterolateral thigh, radial forearm, fibula, and jejunum flaps. Unique issues related to postoperative care and monitoring of head and neck free flaps are discussed. The management of complications, in particular those threatening flap survival, are reviewed in detail.

Original languageEnglish
Pages (from-to)1236-1245
Number of pages10
JournalHead and Neck
Issue number9
StatePublished - 09 2010


  • advances
  • cancer
  • head and neck
  • outcome
  • reconstruction
  • results
  • techniques


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