Temporoparietal fascial flap for reconstruction of open wounds in patients previously treated for head and neck cancer

Wound-healing problems with subsequent plate exposure are frequent in patients who have undergone reconstructive surgery for head and neck cancer. Management of these wounds is difficult. The objective of this report is to present two head and neck cancer patients with chronic facial wounds and plate exposure after radiation therapy. A temporoparietal fascial flap was used to manage the wound in both cases. From January 2009 to January 2013, there were 37 patients with head and neck cancer who required reconstruction of composite mandibular defects in Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. Plate exposure developed in 10 patients, and in two patients the chronic facial wound was treated with a temporoparietal fascial flap. Both the flaps survived, and at 6 months of follow-up the wounds were healed with minimal donor site morbidity. Neither patient experienced alopecia or injury to the facial nerve. The temporoparietal fascial flap is thin, pliable, and well vascularized with a long pedicle, and provides resistant coverage to the recipient site from infection. The temporoparietal fascial flap may be an alternative choice for the reconstruction of head and neck open wounds.