Background: Reconstruction after oral cavity oncologic resection aims to restore speech, mastication, and aesthetics
while minimizing morbidity. Although microvascular free flaps are considered the gold standard, local flaps offer a
simpler and faster alternative, particularly in resource-limited centers. This study compares the clinical and
functional outcomes of local flaps versus free grafts in intraoral defect reconstruction.
Materials and Methods: A prospective comparative study was conducted on 118 patients undergoing oral cancer
resection between January 2021 and September 2024. Patients were divided into two groups: Group A (n = 58)
reconstructed with local flaps (melolabial, submental, supraclavicular, infrahyoid, or platysma), and Group B (n =
60) reconstructed with free grafts (radial forearm or anterolateral thigh). Perioperative parameters, complications,
and functional recovery were analyzed over six months using the Performance Status Scale for Head and Neck
Cancer (PSS-HN).
Results: Mean operative time and hospital stay were significantly lower in the local-flap group (3.1 h and 8.3 days)
than in the free-graft group (6.5 h and 14.2 days) (p < 0.001). Flap-survival rates were comparable (94.8% vs.
91.7%, p = 0.47). Functional recovery at six months showed no significant difference in oral intake or speech
intelligibility between groups (p > 0.05).
Conclusion: Local flaps offer comparable success and function to free grafts while significantly reducing surgical
time and morbidity. They represent a reliable, time-efficient reconstructive option for small-to-medium intraoral
defects in high-volume oncologic settings.
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