Reconstruction of full-thickness buccal defect is challenging as two linings need to be addressed. Either two different flaps or double-paddle for one free flaps are necessary for this defect. The prolonged operation might not be tolerated by patients because of advanced age or medical comorbidity. A 77-year-old gentleman, with significant medical comorbidity, presented with a 4.0 × 4.5 cm ulcerative mass due to squamous cell carcinoma arising from the left buccal mucosa. The tumor extended to the left cheek skin. There was no palpable neck node. CT scan did not show any bony erosion or suspicious neck node. Full-thickness resection of the tumour was undertaken. For the full-thickness buccal defect, a bi-paddled pedicled submental flap after de-epithelialization of the flap skin was used for both the cutaneous and mucosal resurfacing. The flap survived completely and patient recovered smoothly. The surgery is simple and operation time is much shorter than free flap reconstruction. This modified utilization of submental flap simplifies the closure of complicated oro-facial wound.
inevitable exposure to the infection perhaps unwittingly so given that approximately 18,100 (17%) people living with HIV in the United Kingdom (UK) are unaware of their HIV positive status. There is therefore a need for guidance specific to oral and maxillofacial surgery (OMFS) procedures to establish an acceptable threshold of known and unknown risk to both the patient and OMFS personnel with regard to HIV infection, both diagnosed and undiagnosed. Objectives: We explore the surgical opinion of OMFS surgeons within the UK on managing the HIV positive OMFS patient. Methods: An online questionnaire was performed to assess the current awareness of HIV and its management, establish opinions, concerns and the incumbent challenges involved in managing such patients in the context of OMFS. Findings: The majority of clinicians felt they had limited knowledge on the complexities involved in managing such patients and sort clearer additional guidance on how to best optimise this patient group. Conclusion: Clearer guidance is required in the management of the HIV positive OMFS patient and this study will help to inform this.
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