SOFT-TISSUE COVERAGE OF MANDIBULAR RECONSTRUCTION PLATES

Free tissue transfer was compared to pectoralis major flap coverage of mandibular reconstruction plates in a retrospective review. The study group consisted of 14 patients whose composite defects were reconstru cted with metal plates covered with either pectoralis flaps (9) or sof t tissue free flaps (5). Four patients in the pectoralis group (44%) h ad plates that extruded compared to none in the free flap group. The m ean operating room time for the free flap group (721 minutes) was long er than the pectoralis group (550 minutes), but the overall hospital s tay for the free flap group (20 days) was half that of the pectoralis group (39 days). The pectoralis group required more secondary procedur es (88%) than the free flap group (20%). Free flaps have a higher succ ess rate, a shorter hospital stay, and require fewer additional proced ures than do pectoralis flaps. This justifies the longer operating tim e and greater technical complexity of free tissue transfer for reliabl e coverage of mandibular reconstruction plates.