Evaluating the use of anterolateral thigh flaps to prevent reconstruction plate exposure in patients with oral cancer.

OBJECTIVE

Plate exposure remains one of the most serious complications of oromandibular reconstruction. The purpose of this study was to investigate the effect of wrapping reconstruction plates with anterolateral thigh (ALT) free flaps as a way to prevent plate exposure.

STUDY

DESIGN

A total of 91 patients with composite oromandibular defects who underwent surgical reconstruction using a reconstruction plate in conjunction with an ALT musculocutaneous flap were recruited. The participants were divided into 2 groups, based on whether the plate was wrapped with or covered by the ALT flap.

RESULTS

The incidence of plate exposure in the experimental group (17%) was significantly lower than that of the control group (43.1%; P < .0001). The mean time from reconstruction until plate exposure in the experimental group was 19.4 ± 23.6 months, whereas the mean time in the control group was 12.3 ± 9.1 months. In the logistic regression model for the occurrence of plate exposure, the only factor found to be associated with plate exposure was how the ALT flap was used (P = .026).

CONCLUSIONS

The results of the present study indicate that wrapping the reconstruction plate with an ALT flap decreased the incidence of plate exposure in patients with oromandibular defects.