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Oromandibular reconstruction using a third free flap in sequence in recurrent carcinoma
F Demirkan1, F C Wei, H C Chen
1Department of Plastic and Reconstructive Surgery, Chang Gung University, Taipei, Taiwan.
British Journal of Plastic Surgery
|February 16, 2000
Summary
A third free flap reconstruction is feasible and safe for recurrent oral carcinoma. This approach effectively manages complex defects, improving patient quality of life during advanced disease.
Area of Science:
- Oral oncology
- Microsurgical reconstruction
- Free tissue transfer
Background:
- Recurrent oral carcinoma presents significant reconstructive challenges.
- Previous studies reported success with second free flaps, but feasibility of a third remained undetermined.
- Multiple recurrences necessitate repeated surgical interventions and complex reconstructions.
Observation:
- Six patients with multiply recurrent oral carcinoma underwent three separate free flap reconstructions.
- Defect size increased with each recurrence, requiring diverse flap options including vascularized bone transfers initially.
- The third reconstruction utilized soft tissue free flaps with plate fixation for mandibular defects, omitting vascularized bone grafts.
Findings:
- One partial flap loss occurred among 21 free flaps across all reconstructions.
- The third free tissue transfer was feasible, safe, and effective in managing complex defects.
- Patients undergoing third reconstruction experienced improved quality of life, spending more time outside the hospital.
Implications:
- Third free tissue transfer is a viable option for multiply recurrent oral carcinoma.
- Microsurgical reconstruction can prevent complications and enhance patient well-being in advanced oral cancer.
- This technique allows for palliative care outside the hospital setting for patients with limited prognosis.