Microsurgical reconstruction of oral defects with free flaps for patients with oral cancer: an 8 year experience with 153 consecutive cases.

Objective: Oral squamous cell carcinoma (OSCC) is a common type of cancer affecting people worldwide, with still large proportion of patients diagnosed with the disease in the advanced stage. Due to free vascularised tissue transfers, radical cancer treatment and immediate reconstruction are feasible as a one-stage procedure. The aim of this paper is to evaluate retrospectively our experience with free flap reconstruction of oral defects for patients with oral malignancies in advanced stages.

Material and methods: During the 8-year period, 153 patients with oral cancer had undergone simultaneous extirpation of tumor with or without suspicious lymph node removal and reconstruction of the defect with free flap. A total of 157 free-flap reconstructions had been performed for 153 patients. Accordingly, 116 patients had reconstruction of oral soft tissue defect, but 37 patients had complex soft tissue and bone defect reconstruction.

Results: 132 patients had successful free flap surgery with uneventful post surgery period. Flap success rate was 96.8%. Donors site was closed primarily in 58 cases, skin graft was used in 102 cases. Five patients (3.2%) died during post surgery period. Average hospital stay was 20,5 days (from 8 till 44 days). There was no statistically significant correlation found between the patient's age and hospital stay, but hospital stay increased with tumor size (p>0.05).

Conclusion: The application of the best possible reconstruction method that contributes to the fulfillment of expectations and provision of a good functional and esthetical result is enabled by setting proper, realistic reconstruction goals. Microvascular reconstruction with free flaps for oral defects is a safe method with a very high success rate (96.8%).