Versatility of a free inferior rectus abdominis flap for head and neck reconstruction: analysis of 200 cases.

Between 1984 and 1991, 200 inferior rectus abdominis muscle and musculocutaneous free flap transfers were performed for reconstruction of defects or deformities resulting from removal of cancer in the head and neck region. Primary reconstruction was performed in 190 of 200 cases (95 percent), and secondary reconstruction in 10 cases (5 percent). The most common indication was tongue cancer in 78 patients, followed by cancer of the oropharynx. Total flap necrosis occurred in 10 cases (5 percent) and partial necrosis in two cases (1 percent). Donor-site morbidity was minimal. One of the distinct advantages of this flap is that the volume of the muscle and/or the fatty tissue attached to a given skin paddle can be readily adjusted to suit individual requirements. This flap has proven particularly useful for complex or large tissue defects in the head and neck region.