Head and neck reconstruction with a second free flap following resection of a recurrent malignancy

James Knoetgen, Umar Choudry, Stephan J. Finical, Craig H. Johnson

Research output: Contribution to journalReview article

13 Scopus citations


A retrospective analysis of 12 patients with a head and neck tumor recurrence within a previous free flap treated with extirpation and a second free flap is reported. A 15-year experience at Mayo Clinic, Rochester, from 1988 to 2003 of 12 patients (5 men, 7 women) who underwent 25 free flaps is reviewed. The overall flap survival rate was 92%, with a 100% survival rate in the first free-tissue transfer and 85% survival rate in the second free-tissue transfer. There was 1 minor complication (8%) and there were 2 major complications (15%) among the second free flaps. Overall, 10 of 13 (77%) second free flaps were anastomosed to ipsilateral neck vessels. Moreover, in 5 of 13 cases (38%) the same artery and in 7 of 13 cases (54%) the same vein were used for both the first and second free flaps. Reconstruction of the head and neck with a second free flap in patients with a recurrent tumor is safe and effective. The original recipient vessels can often be used for the second reconstruction.

Original languageEnglish (US)
Pages (from-to)378-383
Number of pages6
JournalAnnals of plastic surgery
Issue number4
StatePublished - Oct 1 2005



  • Second free flap
  • Tumor recurrence

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