Regional Flap in Head and Neck Reconstruction- Part I: Philosophy, Submental and Supraclavicular Flaps

Background: Regional (pedicled) flaps for reconstruction of intra-oral defects are acquiring increasing recognition as a safe, reliable choice in selected cases after oral cancer ablation (extirpation). The lower technical demands and suitability for elderly/high-risk patients together with specific features that may resolve the seemingly intractable dilemmas with other approaches, are providing a valuable tool in this challenging area of surgery. Aim: The aim of this paper is to describe our experience with the regional (pedicled) (submental, supraclavicular) flaps with a focus on reliability, function, cosmesis, donor site morbidity and oncological safety. Methods and results: Reconstructive techniques using distal flaps are described in 12 patients. In 8, engraftment was complete, in 3 there was partial necrosis and in 1 case, complete rejection of the flap. Conclusion: Regional (pedicled) flaps are thin, and pliable with good cosmetic and functional results. They can be accomplished in a one-stage reconstruction with minimum morbidity of donor site.