Mucosal prelamination of a radial forearm flap for intraoral reconstruction

Until now the microvascular fasciocutaneous radial forearm flap has been one of several methods favoured for reconstruction of intraoral soft tissue defects after radical resection of squamous cell carcinoma. Mucosal reconstruction and lining has been performed by a skin island, this is epidermis and cannot produce mucus. In order to provide mucosal properties and allow mucus production, a distal radial forarm flap has been successfully prelaminated with buccal mucosa in five patients. By this method thin, pliable and resistant flaps have been produced. Due to mucosal spreading, the mucosa lined area was 30-50% larger than the originally inserted mucosal grafts. Preservation of skin and subcutaneous tisssue lowered donor site morbidity. This technique has also been performed in axial pattern flaps; two osteofasciomucosal fibulae and three myomucosal pectoralis major flaps.