Debulking of free myocutaneous flaps for head and neck reconstruction using an arthroscopic shaver.

Most reconstructive surgeons prefer a myocutaneous free flap for head and neck reconstruction due to its bulk and superiority in bacterial suppression. To obtain proper symmetry and contouring in the head and neck region, ancillary procedures usually have to be performed. Eleven head and neck cancer patients underwent resection and reconstruction with myocutaneous flaps that resulted in unacceptable facial contouring. Delayed flap debulking with an arthroscopic shaver was performed. All 11 patients were satisfied with their facial contouring and symmetry after one session of debulking. There were no complications such as flap necrosis, seroma or haematoma. This novel technique done under local anaesthesia is effective for debulking myocutaneous free flaps and removing fibrotic tissues. It is simple, safe and produces a reliable and satisfactory outcome.