A new method of oral reconstruction using a free composite foot flap.

We present a series of 10 free composite foot flaps used in 9 patients for floor-of-mouth and mandible reconstruction after composite resection. This one-stage repair replaces the soft tissue as well as the bone that has been resected. The flap is easily obtained from the foot, and is tailored to meet the requirements of the mouth and jaw defect. Donor site morbidity is surprisingly low: two flaps were lost from vascular obstruction, and 1 from delayed infection at ten days. The surviving flaps have provided good cosmetic and functional results. Bony union has occurred in half the grafts, and satisfactory firm fibrous union in the remainder. The flap is also useful for late reconstruction in "oral cripples," and may be used with the skin internally or externally as required. We are pleased with the versatility of this flap in complicated reconstructions.