A Comparative Study of Local Flaps versus Non Flap Techniques of Wound Closure Following Resection in Oral Malignancy

BACKGROUND Wound closure is paramount in surgical intervention. Various wound closure techniques are available for reconstructive surgeries. The present study aims to study and compare the postoperative compatibility and outcomes in local flaps with non-flap wound closure techniques following resection in oral malignancy. METHODS The study was conducted at the Department of General Surgery, Kasturba Medical College, and allied hospitals, Mangalore, spanning over a year period from August 2013 to August 2015. Fifty patients who presented with malignancies of the oral cavity were evaluated. All patients were thoroughly examined. All patients were appropriately investigated. Treatment included surgery, chemotherapy, radiotherapy, or a combination. All patients were followed to date. RESULTS Patients in the study population were in the age group of 35 years to 75 years, with the majority being in the 55 to 65 years (48%) age group. The majority of the lesions were located on the lip (26 %), followed by the buccal mucosa (22%), tongue (16%), alveolus (14%), cheek (12%), and floor of the mouth (10%). Among distant flaps, the delto-pectoral flap was the preferred technique used (n = 9), with the pectoralis major myocutaneous flap being used less frequently (n = 5). CONCLUSIONS Reconstruction of defects following surgeries for oral malignancy is an area of frequent investigation/research. The results concluded that local flaps proved excellent for small/early lesions, whereas distant flaps were more useful for significant defects. Local flaps had a lesser incidence of complication than distant flaps. Among the distant flaps, we had better outcomes with pectoralis major myocutaneous flaps than with deltopectoral flaps. The poor nutritional status due to malignancy and nicotine consumption was the leading cause of delayed healing of flaps.