{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:15:02Z","timestamp":1770977702729,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: In recent decades, free flaps have emerged as the gold standard for head and neck reconstruction. However, their use is contraindicated in some cases due to advanced age and\/or comorbidities. In such patients, a pedicled flap may be considered. The aim of this observational study was to evaluate strategies for head and neck reconstruction using pedicled flaps in the era of free flaps. Furthermore, the complication rate was analyzed. Methods: Patients who underwent head and neck reconstruction with pedicled flaps were included. The following flaps were considered: the pectoralis major (PMF), deltopectoral, platysma, frontal, temporal, nasolabial, supraclavicular artery island (SCAIF), infrahyoid, sternocleidomastoid, buccal fat pad, and facial artery myomucosal flap (FAMM). Patients\u2019 characteristics, flap type, recipient sites, and flap-related complications were systematically recorded. Results: A total of 112 pedicled flaps were analyzed. A PMF was most commonly used for tongue and hypopharyngeal reconstruction. Partial and complete flap necrosis occurred in 11.6% and 1.8% of cases, respectively. Wound dehiscence was reported in 12.5% of cases, while pharyngo-\/oro-cutaneous fistulas developed in 6.3% of patients. Hemorrhage from the donor site or flap occurred in 3.6% of cases, and pharyngeal stenosis in 0.9%. Conclusions: Each reconstructive strategy depends on the site and extent of tissue loss. Given the low complication rates, pedicled flaps remain a valid option for head and neck reconstruction in selected patients.<\/jats:p>","DOI":"10.3390\/jpm16020112","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T09:09:19Z","timestamp":1770973759000},"page":"112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Personalized Strategies for Head and Neck Reconstruction Using Pedicled Flaps"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1825-7635","authenticated-orcid":false,"given":"Giuseppe","family":"Riva","sequence":"first","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-2594","authenticated-orcid":false,"given":"Andrea","family":"Canale","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Marco","family":"Motatto","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Talamelli","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Briguglio","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Chivasso Hospital, Via Paolo Regis 42, 10034 Chivasso, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4463-9889","authenticated-orcid":false,"given":"Alice","family":"Bordin","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4109-4318","authenticated-orcid":false,"given":"Teodros","family":"Veronesi","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6884-4563","authenticated-orcid":false,"given":"Giancarlo","family":"Pecorari","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"459","DOI":"10.14639\/0392-100X-1153","article-title":"Head and neck reconstruction with pedicled flaps in the free flap era","volume":"36","author":"Mahieu","year":"2016","journal-title":"Acta Otorhinolaryngol. 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