Head and neck reconstruction surgery is performed to rebuild defects in the face and neck by using blood vessels, bones, tissue, muscle and skin removed from other parts of the body. Skin grafts or healthy tissue flaps are transferred to the affected area of head or neck for reconstruction.
Some of the indications for head and neck reconstructive surgery include:
Surgical reconstruction techniques
Surgical reconstructive techniques for head and neck include:
A skin graft is a healthy patch of skin taken from another part of your body (donor site) to cover the damaged or missing area. Your doctor will choose a skin graft depending on the damaged area.
Flap surgery is the transfer of a piece of tissue from one part to the other part of your body, along with blood vessels. The types of flaps used include:
Local flap: Your surgeon will create a flap from the skin lying close to the wound, along with its underlying tissue and blood supply, and will pull it over the wound.
Regional flap: Your surgeon will use a tissue flap by keeping a specific blood vessel attached to it. The flap will be moved to cover the injured site while keeping a narrow attachment common with the original site.
Free flap or microsurgery (microvascular reconstruction): Your surgeon will remove tissue from regions away from the site of surgery and will connect the blood supply of the flap with those at the new site. This delicate work is performed under a microscope.
Microvascular reconstruction includes:
If your mouth, lower jaw bone, neck or throat has to be reconstructed, your surgeon will perform a temporary tracheotomy (opening of the airway in the windpipe) for safe breathing.
Immediately after the surgery, you will have to be on strict bed rest for 24 hours. You will be hospitalized for 7 – 9 days. In the initial 24 – 48 hours, your free flaps will be checked frequently for viability.
You will be advised to keep yourself well hydrated and take measures to prevent anaemia and clots in the veins. Your doctor will prescribe anticoagulants after a free tissue transfer. You should report to your doctor if you observe presence of bluish colour, or increased swelling and temperature in the transferred flap. You will be assessed with physical therapy or rehabilitation after discharge.
Risks and complications
As with any surgical procedure, head and neck reconstruction involves potential risks and complications. These include: