Microsurgical reconstruction of difficult orocutaneous fistulas

We present 5 cases from a series of eight orocutaneous fistulas that were successfully reconstructed through the use of free tissue transfer. Reconstruction was performed in 5 patients with a radial forearm flap and in 3 patients with a free jejunal transfer. This report addresses the approach to reconstructing the difficult orocutaneous fistula with emphasis on free flap design and the use of a bilaminar flap.