Combined Free Flaps for Major Head and Neck Reconstruction

involving the face and intraoral region were operated upon for extensive excision in desperate attempt to achieve better patient quality of life. The resultant defects required the use of combined latissimus dorsi and serratus anterior n~uscle flaps for reconstruction of the wounds. The procedure can be accomplished in single-stage with only one arterial and one venous anastomosis to the selected recipient vessels. This helps in reducing the operative time. The combined free flaps in both of our cases survived well postoperatively. Microvascular free tissuc transfer is now widely accepted as a very useful and reliable technique that offers great versatility in the sclection of appropriate tissue for reconstruction of head and neck defects as well as certain defects on ot11c1- body parts.'- " The free tissue to be transferred can be simple tissue such as skin flap,7-Vascial flap,' " muscle flap;".'? or as vascularized bone or complex tissue grafts such as mvoclltaneous flap, osteocutaneous flap,"*.' " osteo-septocutaneous flap,l%nd osteonlyocutaneous flap." However, in the case of a vey large defect, a single free tissue transfer mav not be sufficient to resurface or cover the entire defect in a single setting. We herein would like to present our experience in utilizing the combined free flaps that can provide good solution for a very large surgical defect in the head and neck region. PATIENTS AND METHO~