In India head and neck cancer patients usually present in the advanced stage. We have attempted to reduce the local morbidity and wound infection by placing the broad spectrum antibiotic–impregnated gel foam in between the two paddles and discuss the results of our prospective study. In group A consisting of 6 patients local ceftriaxone impregnated gel foam pad was placed between the two paddles of the PMMC flap and in group B consisting of 10 patients no local prophylaxis was given. Systemic IV antibiotics were given for both groups of patient. Within the limitation of small sample size, review of results of our pilot study point towards increased wound–related morbidity and secondary hemorrhage in patients with placement of local antibiotic in between the two paddles of PMMC flap likely due to potential infection and foreign body reaction.