Free lateral thoracic flap in head and neck reconstruction.

Clinical reports of free skin flaps that are transferred by microvascular anastomosis have increased in frequency since the introduction of microvascular surgery. The groin flap with its large area of available skin, reliable donor vessels, and favorable donor scar is probably one of the most frequently used free flaps. However, it has a distinct disadvantage with its short vascular pedicle. The free lateral thoracic flap has a longer vascular pedicle and larger-caliber vessels compared with the groin flap. A vascular pedicle that contains vessels, approaching 2 mm in external diameter and up to 10 cm in length, allows greater versatility in head and neck reconstruction. Once the surgeon has become familiar with the vascular anatomy of the lateral thoracic area, free flap harvest requires less time and is simpler relative to the harvest of the free groin flap.