Composite Resection Reconstruction: Split‐Thickness Skin Graft—A Preferred Option

Abstract

In dealing with reconstruction of the oral cavity postcomposite resection, many options are available. Maximization of function with minimization of complications, physiologic sequelae, and cost must be considered. Fifty consecutive patients who underwent composite resections and were reconstructed by split-thickness skin grafts were analyzed. Factors examined included: number of blood units transfused, disease status vs. stage, length of hospital stay, complications, use of prosthetic devices for aiding in swallowing and speech production, and patient diet at discharge. This evaluation and literature review revealed that the amount of tissue resection was considered to be the most significant functional determinant, followed by maintenance of residual tissue mobility. The use of a split-thickness skin graft was believed to give excellent results for the previously mentioned parameters and is our preferred method for reconstruction of composite resection defects that do not require tissue bulk as in anterior mandible defects, anticipated mandible reconstruction, total or near-total glossectomy, or very massive defects.

Surgical Variables Affecting Speech in Treated Patients With Oral and Oropharyngeal Cancer

“…The extent of surgical resection, particularly the amount of oral tongue resected, has been implicated as the primary correlate of speech impairment in postsurgical oral and oropharyngeal cancer patients. Larger resection volumes and greater percentage of oral tongue resection have been correlated with reduced intelligibility and articulation 1‐5 . Other research, however, suggests that speech function depends on the method of reconstruction rather than the degree of resection 6 .…”

Functional and psychological evaluation after flap reconstruction plus radiotherapy in oral cancer

“…Larger resection volumes and a greater percentage of oral tongue resection have been correlated with reduced speech intelligibility and articulation. [7][8][9][10][11][12] Other factors that could potentially affect speech and swallowing function include segmental mandibular resection [13][14][15] and postoperative radiotherapy (RT). Segmental resection of the mandible impairs the osseous base of the tongue, which may result in functional impairment.…”