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

Objectives: To 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 methods: Thirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. Results: Transplant success was 93%. Mean pedicle length was 13.4 cm. Eleven patients (37%) had vesselpoor 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. Conclusions: The 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. (C) 2017 Elsevier Ltd. All rights reserved.