Perforator based rectus free tissue transfer for head and neck reconstruction: New reconstructive advantages from an old friend

Abstract

ObjectivesTo demonstrate three reconstructive advantages of the perforator based rectus free tissue transfer: long pedicle, customizable adipose tissue, and volume reconstruction without muscle atrophy within a contained space. Materials and methodsThirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. ResultsTransplant success was 93%. Mean pedicle length was 13.4cm. Eleven patients (37%) had vessel-poor necks and the long pedicle provided by this transplant avoided the need for vein grafts in these patients. Adipose tissue was molded in 17 patients (57%). Twenty-five patients (83%) had defects within a contained space, such as the orbit, where it was critical to have a transplant that avoided muscle atrophy. ConclusionsThe perforator based rectus free tissue transfer provides a long pedicle, moldable fat for flap customization, and is useful in reconstruction of defects within a contained space where volume loss due to muscle atrophy is prevented.