Do intraoral radial forearm free flaps re-mucosalise and is candida infection relevant?

Eleven patients, with a mean age of 57 years, who had undergone radial fore arm flap reconstruction following the excision of intraoral carcinoma, unde rwent flap biopsy at a mean of 45 months postoperatively. Seven of the pati ents had received postoperative radiotherapy. In eight patients the clinica l appearance of the flap was similar in colour to that of adjacent normal o ral mucosa; the remaining flaps retained the appearance of normal volar for earm skin. Histological examination of the flaps showed varying degrees of telangiectasia and mild chronic inflammation. In only two patients was supe rficial infection by candida hyphae identified. Intraoral free flaps, altho ugh clinically resembling oral mucosa, retain histological features of skin , at least within the period under study. The erythematous clinical appeara nce was not correlated with the presence of chronic fungal infection, but r eflected the presence of vascular repair tissue, telangiectasia and mild re sidual chronic inflammation. (C) 2001 The British Association of Plastic Su rgeons.