**7. Tips in oral reconstruction**


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**Figure 12.**

*Reconstruction based on size of the defect.*

**Figure 11.**

*Reconstruction based on patient status.*

*Modalities and State of Art in Oral Cancer Reconstruction*

*DOI: http://dx.doi.org/10.5772/intechopen.91049*

• **Figures 11** and **12** show a rational approach in oral reconstruction.

#### *Modalities and State of Art in Oral Cancer Reconstruction DOI: http://dx.doi.org/10.5772/intechopen.91049*

**Figure 11.**

*Oral Diseases*

**5. Care of flaps and donor site**

**6. Future directions**

**7. Tips in oral reconstruction**

reconstruction.

The use of flaps in reconstruction requires special care in terms of surveillance of perfusion and integration. The pediculate flaps usually do not jeopardize the perfusion, but sometimes a minor venous congestion can be expected. As a preventive measure, any intent must be done to avoid tension or compression of the vessel that perfuses the flap. The free flaps require special attention due to the risk of arterial or venous thrombosis and flap failure. Strict vigilance during the first 72 h after surgery and searching for signs of an early venous congestion or arterial occlusion can detect early failure of the flap and may permit in many cases a successful intervention to preserve the flap. The use of Doppler monitoring may help to reach that goal.

The donor site when skin grafted may be left secured and covered with wet gauze up to 8 days to reach adherence of the tissue. Sometimes small bleeding is expected with no need of a revision surgery. If the donor site is primary closed, surveillance of a compartment syndrome is necessary especially if it is closed is under tension.

Reconstruction has been evolving during the last 20 years. Access to technology is assisting the planning of the resection and reconstruction. Additionally, 3D printers will better permit in the future to mimic tissue, so almost a perfect design of the tissue to reconstruct will be performed. Even that, function of some organs like tongue jet cannot properly be replaced, so much work is still necessary to reach that goal. New techniques in surveillance in microvascular perfusion like specific measurement of flap perfusion zones with heat chambers are being developing.

• In oncological resection, patient survival must be guaranteed being the main

• The best reconstruction is the less invasive and time consuming that could achieve the aim of adequate function, esthetics, and rehabilitation.

• Clinical condition of the patient, comorbidities, and status performance may limit a long-time procedure, so a local or pediculate flap must be choose.

• Whenever possible a local or pediculate flap is preferred if reconstruction outcomes are going to be as similar as to a free flap reconstruction.

• Free flap reconstruction when indicated must be done to restore or improve function and cosmetic end and needs a team with skills in microvascular

• Adequate knowledge of different alternatives in reconstruction provides the best comprehensive approach to reconstruct defects based on the location, size,

color match, function, and complexity of structures involved.

• **Figures 11** and **12** show a rational approach in oral reconstruction.

• Satisfactory reconstruction favors rehabilitation and quality of life.

goal to take a decision in terms of reconstruction.

**154**

*Reconstruction based on patient status.*

**Figure 12.** *Reconstruction based on size of the defect.*
