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1 Senior Resident, Department of Plastic Surgery, Bangalore Medical College and Research Centre, Bangalore, Karnataka 2 Assistant Professor, Department of Surgical Oncology, Bangalore Medical College and Research Centre, Bangalore, Karnataka 3 Professor and Head of the Department, Department of Plastic Surgery, Mysore Medical College and Research Institute, Mysore, Karnataka 4 Postgraduate, Department of General Surgery, Mysore Medical College and Research Institute, Mysore, Karnataka Corresponding Author Dr Sunilkumar Mallanaik Senior Resident, Department of Plastic Surgery, Bangalore Medical College and Research Centre, Bangalore, Karnataka, India Email: ssunilkumar87q@gmail.com, Mobile No: +91-9481652424 Abstract Background: The Free Flaps are the “workhorse” in the Reconstruction of Head and Neck Malignancy Composite Resections. Use of free flaps has less clarified and the failure of free flap remains undermined. Materials and Methods: This is a retrospective analysis of the cause and outcome of failed free flaps (and pedicled flap transfers performed at tertiary hospital) for head and neck tumours done at a tertiary care center. The consecutive cases of Head Neck Reconstructions done from Dec 2015 to Dec 2016 were taken for the study. Results: Over the past 1 year (2015-16), there are 33 head and neck reconstructions were performed, 20 by free-tissue transfers and 13 pedicle flaps for head and neck tumours. About 6 flaps failures (18% total plus partial failure rate) were encountered of which four free flap failures and 2 pedicled flap partial failures were noted. Among them one PMMC and one Deltopectoral, were debrided and later Secondary Skin grafting done. Conclusion: In conclusion, Tissue transfer is more effective in the head and neck region tissue. Second flap surgery is not much effective in the head and neck region. Keyword: Free flap surgery, reconstruction, head and neck tumours, pedicle flaps.

The Outcome of Failed Flaps in Reconstruction of Head and Neck Malignancy Resections: what is the Next Reconstruction Option?