IS TRANSPOSED SKIN TRANSFORMED IN MAJOR HEAD AND NECK MUCOSAL RECONSTRUCTION

We used histological and histochemical methods to investigate the poss ible changes with time in skin transposed into the oropharynx and oral cavity of patients whose surgical wounds were reconstructed with the classic pectoralis major flap. We found histological evidence that ski n morphology was maintained (keratinization with reduced, but the desq uamating layer, hair follicles, sweat and sebaceous glands were identi fiable), and noted an intense inflammatory reaction in the dermis. His tochemical studies confirmed the progressive flattening of the basal i nterdigitations between the epithelium and dermis, and the gradual rec onstruction of the basement membrane. Although skin-mucosa continuity developed fairly quickly without scar reactions, the two epithelia mai ntained their original patterns of keratin production, i.e., their tex tural peculiarities. We propose an original method for the transpositi on of muscular flaps implanted with autologous culture of keratinocyte s, an approach developed in an attempt to ensure more satisfactory reh abilitation of the removed mucosal structures.