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Free colon transfer for resurfacing large oral cavity defects
1Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Mo., USA.
Plastic and Reconstructive Surgery
|October 1, 1995
Summary
Free colon transfer offers functional oral lining reconstruction for large defects. This technique provides a durable, thin, and supple mucosal surface, restoring speech, swallowing, and denture function.
Area of Science:
- Surgical Reconstruction
- Oral Oncology
- Gastrointestinal Surgery
Background:
- Reconstructing the oral cavity requires a lining that is durable, thin, supple, and innervated.
- Ideal oral lining facilitates deglutition and speech while maintaining lubrication.
Observation:
- Free transverse colon segments were used as free flaps on middle colic vessels for extensive oral defects.
- Defects involved the alveolar ridge, buccal mucosa, floor of the mouth, tongue, and pharyngeal walls.
Findings:
- All three free colon transfers were successful, with no vascular events, abdominal complications, or oro-cutaneous fistulas.
- The colon mucosa adapted to create a thin, smooth, supple lining, producing mucus and withstanding mastication and denture use.
- Postoperative biopsies confirmed normal colon mucosa with mucin-producing cells, even after 2 years in a non-radiated flap.
Implications:
- Free colon transfer is a viable "functional" reconstruction for large oral defects, preserving speech, swallowing, and denture wear.
- Abundant donor tissue allows resurfacing of complex oral surfaces with thin, mucus-secreting tissue.
- Non-irradiated colon mucosa offers potential for enhanced mucin production via topical or systemic agents.