MUCOSAL PRELAMINATED FLAPS FOR PHYSIOLOGICAL RECONSTRUCTION OF INTRAORAL DEFECTS AFTER TUMOR RESECTION

In order to provide vascularised mucosa for reconstruction of intraora l defects after radical tumour resection, 5 distal radial forearm flap s and 1 fibula flap were prelaminated. Prelamination was performed by fixing small, full thickness mucosa pieces onto the fascia and coverin g the mucosa with an alloplastic sheet as large as the future flap. Th e alloplastic material was a silicone sheet (n = 2), a Gore-tex sheet (n = 3) or a titanium sheet (n = 1). The mucosa and the alloplastic ma terial were covered by the skin and subcutaneous tissue which had been elevated to expose the fascia. With the silicone and titanium sheets, the mucose spread on the fascia and the final flaps were thin, pliabl e, mucus-producing and larger than the original mucose pieces. With th e Gore-tex sheets, extension of the mucosa was prevented by adhesions and the area of mucosa on the final flap was the same size as the orig inal graft. The six prelaminated flaps were harvested after 8-10 weeks . During this time the patients had radiotherapy and chemotherapy. Pre serving the skin and subcutaneous tissue reduced donor site morbidity. Six patients had intraoral defects successfully reconstructed with mu cus-producing prelaminated flaps.