Deltopectoral flap revisited: role of the extended flap in reconstruction of the head and neck.

The extended deltopectoral flap is still the best choice in selected cases. During the period 1987-2004, 34 patients required reconstruction of the head and neck using this flap. Twenty-nine had had one or more failed attempts at microsurgical reconstruction after excision of cancer. Five were treated primarily. The flap was divided at least three weeks after the primary operation. All 34 survived, and there were no donor site complications. Twenty-seven patients had an uncomplicated outcome, but the remaining seven required later closure or skin grafting, usually under local anaesthesia, for complications. The extended deltopectoral flap has been used successfully to provide stable coverage of defects in the head and neck and should remain in the armamentarium of reconstructive microsurgeons.