title: Skin grafts used in combination with free flaps for intraoral oncological reconstruction.
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.
authors.affiliation: Department of Plastic Surgery, The University of Texas, M.D. Anderson Cancer Center, Houston 77030-4095, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Butler
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures; D016038:Skin Transplantation; D013524:Surgical Flaps