The extended single transverse neck incision for composite resections.

An extended single transverse neck incision was used in an unselected group of 40 patients undergoing a composite resection for carcinoma of the head and neck. While 21 of the 40 patients had a fistula and wound infection develop, carotid artery exposure due to flap necrosis occurred in two patients while carotid artery rupture occurred in only two. The extended single transverse neck incision results in a viable flap because of its excellent blood supply. Despite being subjected to fistula formation and infection, it usually results in excellent carotid artery protection, adequate surgical exposure, minimal cosmetic deformity and does not interfere with primary or secondary reconstruction.