Bilobed chest flap.

The bilobed chest flap is presented as an additional method of reconstruction in head and neck surgery. The flap is a combination of two previously described flaps: the deltopectoral flap and the anterior-superior-oblique chest flap. It is based on four perforating vessels supporting an area of 480 to 560 sq cm. The superior and inferior lobes can be used simultaneously for external cervical coverage or in combination for external coverage and internal lining. The importance of this flap is appreciated in the patient who needs two deltopectoral flaps but who has had previous chest surgery on one side, or in one who requires two deltopectoral flaps with a planned fistula which then requires a third flap for closure.