INTRAORAL RECONSTRUCTION USING A 2ND FREE-FLAP FOR RECURRENT OR METACHRONOUS CARCINOMA

A retrospective review of clinical records at Canniesburn Hospital has identified 6 patients in whom intraoral squamous carcinomas were exci sed and reconstruction performed by free tissue transfer on two separa te occasions. The interval between procedures ranged from 8 months to 8 years. One dorsalis pedis flap was used and the other tissue transfe rs were radial forearm free flaps, two of which were osteocutaneous. O ne flap completely failed and the rest survived.There was no evidence of greater risk in carrying out a second microsurgical intraoral recon struction in this series, 4 out of 6 patients remain alive following t heir second procedure, one after 9 years. The results suggest that in selected cases it may be worthwhile to carry out a major intraoral rec onstruction on more than one occasion.