OBJECTIVE: To present two cases in which an improved rhombotrapezius flap design was utilized maximally to cover a wide and deep surgical defect after extirpation of a malignant tumor in the temporo-facial area. SETTING: Tertiary Hospital. PATIENTS AND METHODOLOGY: Two cases of malignancy involving the temporo-facial area of the head are presented. Surgical design for the reconstruction of this defect using rhombotrapezius flap is presented. RESULTS AND DISCUSSION: Large and deep temporo-facial defects are adequately closed by rhombotrapezius flap with adequate tissue coverage. Surgical design proved to be acceptable with good flap take and overall cosmetic result. CONCLUSION: Rhombotrapezius flap can be used to cover a large deep defect and can provide more than adequate tissue coverage and bulk to any temporo-facial defects. (Author)
CASE REPORTS

OBJECTIVES: Axial flap surgery is associated with numerous complications. The purpose of this study is to determine the frequency of these complications, and identify possible factors contributory to their occurrence.

METHODS:
Design: Cross-Sectional Study

Setting: Tertiary Public University Hospital

Subjects: Records of all patients who underwent axial pedicled flap reconstruction at the otorhinolaryngology ward of our tertiary public university hospital from January 2013 to July 2015 were retrospectively reviewed, and data consisting of age, sex, diagnosis, disease stage, smoking history, alcohol intake, co-morbidities, past operations, pre-operative hemoglobin and albumin, total operative time, total blood loss, location and total area of the surgical defect and length of hospitalization were tabulated.  All complications were listed. Data were analyzed for any potential trends.

RESULTS: A total of 38 patients underwent axial pedicled flap reconstruction in the study period. Nineteen out of 38 (50%) cases involved complications. The most common complication was infection. Most of the complications occurred in males with history of alcohol intake, advanced cancer stage, significant blood loss, recurrent tumors, low pre-operative hemoglobin and albumin levels, and a large area of surgical defect.

CONCLUSIONS: The complication rate for axial flap surgery in our series was significant at 50%. Potential risk factors identified were male gender, advanced cancer stage, tumor recurrence, alcohol intake, low pre-operative hemoglobin and albumin levels, significant blood loss, longer operative time, and a larger surgical defect.

Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Surgical Flaps