Ulnar fasciocutaneous free flap for reconstruction of oral cavity defects: a retrospective review

176 frontotemporal = three, parietal = one, parietotemporal. The average age of patients was 53 years (range, 25–81 years). Scalp defects resulted either from tumour resection (two patients), posttraumatic loss of the scalp (three patients) and electric burn (one patient). As a surgical reconstruction, galea-aponeurotic flaps and split-thickness skin grafting was performed in two cases, a temporal muscular flap was performed in one case and a latissimus dorsi free flap was performed in two cases. Conclusion: Scalp reconstruction represents a challenge, as the reconstructive surgeon should strive for a cosmetically appealing result as well as for durable coverage to the exposed cranium. Although local flaps have been described for the reconstruction of these defects, free flaps are the preferred choice when a significant area of soft tissue coverage is required or when the defect concerns also the bone. http://dx.doi.org/10.1016/j.ijom.2017.02.601 Reconstructive surgery of corrosive burn sequela of the oral cavity

Objectives: To evaluate recurrence of BCC after surgery; evaluate functional and cosmetic outcome using radial forearm free flap (RFFF) reconstruction. Methods: A 75-year-old male patient with blackened skin at right cheek for the past three months; initially like black spot; gradually became larger, itching, no discharge. Based on clinical and histopathological examinations, it was diagnosed as giant nodular BCC with telangiectasia and pigmented areas. The treatment was wide excision using RFFF reconstruction. Findings: Wide surgical excision is considered a good treatment option for all BCCs arising on the face. Reconstruction using RFFF offer coverage defects or provide density for recreation of defect and provide well-vascularised tissue. Conclusion: The treatment goal of BCC was to completely remove the tumour and continuous follow-up to detect local recurrence, and provide contour at surgical defect by using RFFF reconstruction. http://dx.doi.org/10.1016/j.ijom.2017.02.603

M. Bouzaiene ∗ , H. Touil

Ulnar fasciocutaneous free flap for reconstruction of oral cavity defects: a retrospective review

University Hospital Center, Mahdia, Tunisia

S. Caldroney ∗ , N. Aslam-Pervez, N. Ghazali, J. Lubek

Corrosive lesions of the upper digestive tract are well documented in the literature. Ingestion of acids and sodas may be intentional or accidental. The spectrum of lesions is variable depending on the affected organs, together or separately: oesophagus, stomach and duodenum. The oral cavity is rarely affected. Microstomia, ankyloglossia, teeth loss, vestibular synechia, alteration of facial expression and speech disorder represent the main sequela of caustic lesions reported in the oral cavity. We report the clinical case of 27-year-old woman who was a victim of burns of the oral cavity due to the accidental ingestion of a very corrosive descaling agent in October 2008. She underwent two prior surgeries at another department without any improvement. When she presented at our department, she was very weak suffering of a severe anaemia and weighing 35 kg. Situation that was incompatible with survival. After a period of reanimation and blood transfusions, we performed under general anaesthesia and intubation with nasofibroscopy a reconstructive surgery after tissue debridement using a pedicled latissimus dorsi flap to obtain a satisfactory mouth opening. The therapeutic strategy and postoperative care are discussed in this work.

University of Maryland Medical Center, Baltimore, MD, United States

http://dx.doi.org/10.1016/j.ijom.2017.02.602 Wide excision of giant basal cell carcinoma on the right cheek using radial forearm free flap reconstruction: a case report S. Bulan ∗ , A. Hardianto, H.Y. Yusuf Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia Background: The basal cell carcinoma (BCC), a malignant neoplasm derived from non-keratinising cells that originate in the basal layer of the epidermis. BCC are slow growing, locally destructive, metastasis is extremely rare, occurring in 0.0028–0.55% of cases, but fatal outcomes are possible due to locally destructive growth into vital structures and recurrent problem after surgery.

Objective: Evaluate patient outcomes and donor site morbidities with the use of the ulnar fasciocutaneous free flap (UFFF) in oral cavity reconstruction. Methods: Retrospective chart review was performed of all patients who underwent UFFF reconstruction for an oral cavity defect at a tertiary care cancer centre. Data evaluated included patient demographics, comorbidities and perioperative details. Both subjective and objective donor site outcomes including Mayo wrist score were reviewed. Findings: Seven males and 4 females were included (n = 11). Average age was 53 years (range, 30–80 years). Preoperative Charlson Comorbidity score ranged from 2–5. The most common pathology and defect reconstructed were squamous cell carcinoma (n = 10) and tongue (n = 7) respectively. Average flap harvest time was 80 min and mean UFFF size was 31.9 cm2 . The mean area of tissue defect that was reconstructed was 60.44 cm3 (range, 20–110 cm3 ). Mean follow-up time was 19.2 months. All flaps survived with good functional outcome. Postoperative Mayo wrist score ranged from 75–100 (average, 93). All donor sites required a split thickness skin graft that healed without complication. Conclusions: The UFFF is a good alternative reconstructive option as compared to the radial forearm flap. Similar qualities include ease of harvest, thin pliable tissue, reliable pedicle and minimal donor site morbidity. Advantages include a less hairbaring tissue that can be utilised in those situations where the dominant hand perfusion is based upon the radial artery. http://dx.doi.org/10.1016/j.ijom.2017.02.604