Skin grafts used in combination with free flaps for intraoral oncological reconstruction

Ann Plast Surg. 2001 Sep;47(3):293-8. doi: 10.1097/00000637-200109000-00012.

Abstract

Surgeons have relied less on skin grafts for intraoral reconstruction by extending free flap tissue onto adjacent areas that could be potentially skin grafted. Split-thickness skin grafts provide thin, reliable epithelial coverage to tissue beds that can be grafted without requiring additional flap tissue. The combined use of split-thickness skin grafts with free tissue transfer may be advantageous in select situations. Four patients underwent intraoral tumor resection with immediate reconstruction using free tissue transfer and split-thickness skin grafts. Skin grafting the tongue component of combined hemiglossectomy and floor-of-mouth (FOM) defects rather than spanning the tongue-FOM junction with flap tissue may prevent excessive bulk, improve tongue mobility, and reduce the size requirement of the flap. A split-thickness skin graft can be applied to the intraoral surface of free flaps used to reconstruct through-and-through orocutaneous defects, reducing the complexity of flap design and inset. Maxillectomy defects reconstructed with muscle flaps can be epithelialized immediately with the application of a split-thickness skin graft to provide a stable obturator cavity. In select cases, the combination of split-thickness skin grafts and free tissue transfer may have advantages over the use of flap tissue alone to cover the adjacent areas of a complex defect capable of being grafted.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Male
  • Maxillary Sinus Neoplasms / surgery
  • Middle Aged
  • Mouth Neoplasms / surgery*
  • Plastic Surgery Procedures
  • Skin Transplantation*
  • Surgical Flaps*