BEHAVIOR OF RADIAL FOREARM SKIN FLAPS TRANSPLANTED INTO THE ORAL CAVITY

Radial forearm skin flaps transplanted into the oral cavity in patient s undergoing treatment for intra-oral tumors frequently acquire a gros s appearance resembling that of buccal mucosa. This article reports st udies of biopsies of the flaps in 53 patients, of which 21 showed chan ges at some stage in the follow-up period. The project aims to determi ne whether 1) the change in the epithelium to a mucosal form is genuin e or reactive, 2) a creeping replacement of epidermis results from the surrounding buccal epithelium, 3) alterations in the epidermis could be associated with changes in the dermis, 4) the change is caused by r adiotherapy. Examination of the biopsies by resin histology and transm ission electron microscopy shows that the changes may be reversible: i t suggests that they are reactive in nature, and related to the degree of dermal inflammation, rather than to the effect of radiotherapy. Th e dermis persists as such and is not replaced by buccal lamina propria . (C) 1998 Wiley-Liss, Inc.