We read with great interest the article "Reconstruction of Extensive Head and Neck Defects with Multiple Simultaneous Free Flaps" by Dr. Hanasono and colleagues. We work on the west coast of Taiwan and see our fair share of head and neck cancers. We also have, on numerous occasions, performed two simultaneous free flaps for reconstruction. We have seen the successes that Hanasono et al. and Wei et al. have described. We further agree with Dr. Hanasono that regional pedicled flaps should be reserved as a "lifeboat" for any unforeseen circumstances.
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