Application of flap economics in head and neck reconstruction.

Background: The Kiss flap technique, aligned with flap economics, has gained traction in head and neck cancer reconstruction. This study evaluates "classic" and "non-classic" Kiss flap methods and explores flap economics principles. Methods: We retrospectively analyzed 50 patients undergoing head and neck cancer surgery with Kiss flap reconstruction between January 2016 and May 2023. Results: Patients (34 males, 16 females; mean age 53) were categorized into "classic" (n = 27) and "non-classic" (n = 23) groups. Seventy percent exhibited good postoperative healing. The anterolateral thigh (ALT) flaps showed the highest stability and lowest complication rate (21 %), followed by radial forearm free flap (RFFF) (30 %), pectoralis major myocutaneous flap (PMMF) (46 %), and Fibula (50 %). Conclusion: Both Kiss flap techniques represent viable alternative options for head and neck reconstruction in complicated cases. ALT flaps offer superior stability. Flap economics aids in resource optimization, emphasizing personalized flap selection for optimal outcomes.