Enhanced Flap Technique Achieves 100% Success Rates in Head and Neck Reconstruction: Study Finds - Video

Osaka Metropolitan University researchers have developed a technique for head and neck reconstruction that shifts the placement of transferred tissue with blood vessels attached, offering a safer, faster option for patients with complex tissue defects, especially those at high risk. The findings are published in Plastic and Reconstructive Surgery – Global Open.

Head and neck reconstruction plays a crucial role in the treatment of patients with head and neck cancer. The goal is to preserve functions vital for breathing, eating, and speaking, while maintaining the patient’s appearance and quality of life.

“Traditional reconstruction typically uses free flaps, which may not be feasible for some patients, such as those who have had prior radiation treatment or multiple surgeries,” said Tsubasa Kojima, a medical doctor and lecturer at Osaka Metropolitan University’s Graduate School of Medicine and lead author of the study.

The research team cut a new path and worked instead with pedicled flaps taken from the back, called pedicled latissimus dorsi (LD) myocutaneous flaps. Unlike free flaps, pedicled flaps remain partially attached to the donor site, retaining their natural blood supply as they are transferred to the recipient site for reconstruction.

While the latissimus dorsi flap has been used in various reconstructive surgeries, the team developed a unique approach that placed the skin portion of the latissimus dorsi flap more distally, or lower on the back, than in conventional techniques. This design includes the lateral cutaneous branch of the 10th posterior intercostal artery, ensuring reliable blood flow to the flap.

The study, conducted between 2003 and 2024, demonstrated that the pedicled latissimus dorsi flap was successfully integrated in all 22 patients with complex head and neck defects.

Reference: Kojima, Tsubasa MD; Motomura, Hisashi MD, PhD; Nochi Deguchi, Ayaka MD; Maeda, Shusaku MD; Kang, Songsu MD. Salvage Operation of Head and Neck Reconstruction Using a Pedicled Latissimus Dorsi Myocutaneous Flap with Distally Positioned Skin Paddle. Plastic & Reconstructive Surgery-Global Open 12(10):p e6199, October 2024. | DOI: 10.1097/GOX.0000000000006199