Oral carcinoma is the most common cancer among males in India. Treatment involves resections that lead to complex defects, causing significant changes in functional and aesthetic outcomes and affecting the quality of life of patients.
Planning a flap procedure includes precise analysis of the defect and the quality and quantity of tissue available for reconstruction.
Minor defects can undergo primary closure, whereas medium-sized and large defects require local, regional, or free flaps for reconstruction.
The choice of reconstruction differs for each subsite. One-third of defects following tongue carcinoma resection can be primarily closed due to the availability of sufficient mobile tissue.
However, this may not apply to small buccal mucosa defects, where primary closure could lead to trismus.
ORAL SURGERY: A prospective, quantitative study on the clinical outcome of Inferior Alveolar Nerve decompression and neurolysis
Larger defects may require local or free flap reconstruction to provide bulk and contour.
Local flaps are harvested near the defect and usually provide color and texture matching.
They are relatively easy and quick to harvest, suitable for patients with significant comorbidities, and do not need special instruments or skills.
In selected cases, studies have shown that local flaps have similar functional outcomes and complication rates as
compared to free flaps.
Nevertheless, replacing “like with like” remains the ultimate goal in achieving optimal oral defect reconstructions.
Functional outcomes with free flaps are superior in cases where large, complex, and osseous reconstruction is required. Nevertheless, local flaps are a good option in selected medium-sized defects with minimal donor
site morbidity.
In settings where a significant discrepancy exists between the high volume of patients and the number of free flap reconstructions, there is an unmet need for appropriate flap reconstructions.
From this perspective, the utilization of local flaps in various subsites of the oral cavity, without comparisons to free flap reconstructions, merits exploration.
Hence, this study retrospectively reviews the various types of local flaps utilized at our Institute and provides a comprehensive overview of the related surgical techniques, indications, and complications.
