Double free flaps in oral cavity and oropharynx reconstruction: Systematic review, indications and limits

Giuditta Mannelli, Luca Gazzini, Lara Valentina Comini, Giampiero Parrinello, Riccardo Nocini, Daniele Marchioni, Gabriele Molteni

Research output: Contribution to journalReview articlepeer-review


The simultaneous use of two different free flaps, harvested from distinct donor sites, has demonstrated a reasonable degree of safety and success rates in head and neck composite defects reconstruction. Unfortunately, their relatively low frequent use, together with the lack of proper statistics on their management strategies, make their indications weak of robust conclusions to better define their role in common practice. The aim of the present study was to review the literature of the last 15 years regarding simultaneous free flap transposition, presenting advantages, disadvantages, and results of this technique, with the final purpose to propose an up-to-date panorama for the use of double free flap for complex head and neck defects reconstruction. Depending on which factors are present, surgeons may choose to select an approach that is theoretically safer, but yields less-than-ideal functional outcomes, such as local flap. Two free flaps may be necessary when the defect contains both a large, complex bony defect, large soft tissue needs, and proper surgical planning and meticulous monitoring continues to be the cornerstone of success.

Original languageEnglish
Article number104637
JournalOral Oncology
Publication statusPublished - May 2020


  • Composite defects
  • Double flaps
  • Free flap indication
  • Free flaps
  • Head and neck reconstruction

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research


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