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Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However, despite this,...

How I Do It - Surgical skin cancer treatment: non-melanoma skin cancer

The surgical management of skin cancer, particularly extensive lesions, may require a specialist surgeon with a reconstructive repertoire. The management of such lesions should be within the remit of a multidisciplinary team (MDT). Surgery should be carried out with good...

Treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy

The debate amongst head and neck surgeons, as to whether a skin flap or enteric flap offers superior outcomes in pharyngeal reconstruction, still rumbles on. The evidence pool is very shallow, even accounting for the so-called ‘landmark’ papers that swung...

A useful regional flap for head and neck reconstruction

This article explains the experience of the head and neck department of the Massachusetts Eye and Ear Infirmary with a seldom used regional flap, the supraclavicular artery (SCA) fasciocutaneous flap. This versatile flap is based on the supraclavicular artery, a...

The double-half bilobed flap or traditional bilobed flap – which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various sub-units to achieve best results. The traditional superiorly based...

The three stages of breast reconstruction

Breast cancer has become so common that most people reading this article will know someone (either professionally or personally) who has been affected by breast cancer. One of the most common treatments for breast cancer is removal of the ‘whole’...

Skin grafts vs local flaps in reconstruction of nasal defects

Nasal defects commonly are a result of removal of skin lesions. Cosmetic outcomes of local flap reconstructions are commonly accepted to be superior in comparison to skin grafts. However, local flap reconstructions require more adjunctive procedures than single-stage operations based...

Cheek reconstruction following melanoma excision

Malignant melanoma occurs most commonly on the cheek and thus are usually diagnosed early, rarely needing large reconstructions following advanced disease. This is a retrospective looking at 26 patients identified that had undergone treatment for cheek melanomas between 1996 and...

Total lower lip reconstruction

Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. Defects usually involve the full thickness and include skin, muscle and mucosa. There are a number of techniques for the one stage...

Total lower lip reconstruction: a review

Total or near total defects of the lower lip may result from trauma, cancer ablation or congenital causes. Defects usually involve the full thickness and include skin, muscle and mucosa. There are a number of techniques for the one stage...

Modifying the DIEP flap in autologous breast reconstruction, introducing a fifth ‘Fleur-de-lis’ zone

With current consumer disquiet about silicone implants, more patients may request autologous reconstruction. This can cause difficulties in patients who have undergone massive weight loss. The authors describe an ingenious solution, modifying the deep inferior epigastric perforators (DIEP) flap to...

Rib grafts for mandibular reconstruction

The mandible provides support for the function of the lips, floor of mouth and tongue, and provision of oral competence and function such as swallowing, chewing and speech. Reconstruction of the mandible following ablation thus requires good bone stock to...