Abstract
Background
To investigate the risk factors for plate exposure in primary oral cancer patients
with mandibular defects undergoing tumor ablation followed by vascularized free fibular
flap (FFF) transfer, we conducted a retrospective observational study in a single institution in Taiwan.
Methods
The study was performed on a total of 292 primary oral cancer patients who underwent
FFF reconstruction between 2015 and 2019. A variety of clinicopathological, surgical,
and postoperative parameters were identified and assessed. The data were statistically
analyzed with univariate and multivariate logistic regression, and the probability
of plate exposure-free rate was plotted as Kaplan-Meier survival curve.
Results
The overall plate exposure rate was 28.76%. The re-exploration group had a higher
rate of plate exposure than patients without re-exploration (12.2% vs. 5%, p < 0.05). The 3-year probability of plate exposure-free rates in patients with (n = 216) and without (n = 76) postoperative radiotherapy were 65.9 and 92.5%, and in patients with (n = 141) and without (n = 151) postoperative wound infection were 55.3 and 91.2%, respectively. The multivariate
logistic regression showed postoperative radiotherapy and wound infection were independent
risk factors for developing plate exposure (adjusted odds ratio [95% CI]: 3.73 [1.37–10.68]
and 10.71 [5.15–22.26], p = 0.01 and p <0.001, respectively). More patients required surgical intervention to manage the
exposure of hardware.
Conclusion
Our study has highlighted that postoperative radiotherapy and postoperative wound
infection are independent risk factors for plate exposure.
Keywords
plate exposure - mandible reconstruction - fibula flap - oral squamous cell carcinoma
(OSCC)
