Objective: To analyze the rationale and feasibility of double free flap transfers for reconstruction of extensive head and neck defects.

Methods: Thirty-three consecutive cases of double free flap transfers for extensive head and neck defects from March 2000 to January 2002 were reviewed. Data concerning the operation included date of surgery, defect description and site, choice and combination of flap, recipient vessel and complications.

Results: The fibula osteocutaneous-radial forearm fasciocutaneous flap combination was most commonly used (n = 23), followed by the fibula osteocutaneous-rectus abdominis myocutaneous flap (n = 6) and radial forearm-rectus abdominis myocutaneous flap(n = 4). The complete flap survival rate was 97.0% (64 of 66 flaps).

Conclusion: In selected cases, the double free flap procedure for reconstruction of massive head and neck defect is justified and effective, and greatly improve the quality of life for these patients.

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