Soichi TANAKA, D.D.S., PhD
Abstract:
Sometimes we meet the extra-oral reconstruction plate exposure that is
caused by bacterial infection or other situation. When it occurs, we need the incision and drainage (I & D) or immediate debridement. Especially when it is accompanied with
infection that due to the existence of reconstruction plate, we need to remove
the plate. However, removal of the plate often leads to the loss of oral function
and causes the poor esthetic outcome. Therefore, other reconstruction methods
need to be considered.
The patient was 84-years old woman with lip ulcer. Pathological diagnosis
was squamous cell carcinoma. As the metastatic lymph node was adhered to the
mandibular bone, the mandible was resected with primary lesion. The defect was
reconstructed with forearm flap and titanium plate. Unfortunately, titanium
palate was exposed on submental area after surgery.
As the treatment modalities, we chose Negative
Pressure Wound Therapy with a V.A.C system in combination with Hyperbaric
Oxygen Therapy (HBO) and fibroblast growth factor. As the result, the exposed
reconstruction plate was covered with normal tissue.
