Availability of Primary Closure for Resection of Oral Cavity Cancer

Abstract

Resection of malignant lesions in the oral and maxillofacial area causes functional and morphological defects. In order to recover from these defects, reconstruction surgery is needed, such as a primary closure or a flap. There are advantages and disadvantages to the method of using the primary closure and the flap, and the choice of procedure is entirely up to the surgeon. The purpose of this study is to evaluate the availability of primary closure in patients. For 10 years, from January 2010 to May 2020, patients who recovered using flaps after removing malignant lesions from the oral cavity and those who closed the lesion using primary closure were investigated. The investigation was conducted by searching the database of the hospital. There were 85 patients who removed malignant lesions in the oral and maxillofacial area, and among them, 16 patients closed the soft tissue defects using primary closure. Operation time, histologic types, stages, wound status, and period of hospitalization according to the patient’s medical records were investigated retrospectively. Between the staging and the primary closure, statistically significant differences were observed between stage I and stage II patients in 13 patients using the primary closure. (p = 0.046). Statistically significant differences were identified between operation time and primary closure, with an average of 4.02 h (p = 0.015). The average period of hospitality for patients who underwent primary closure was 13.4 days, compared to 26.7 days for those who underwent flap surgery. This difference was statistically significant (p = 0.0003). As a result of three-way ANOVA analysis on operation time and hospital stay, only neck incision, reconstruction method (flap or primary suture), and intrastage reconstruction method had a statistically significant effect on operation time and period of hospitality. This study evaluated the use of primary closure in patients who underwent resection of malignant lesions in the oral and maxillofacial area. Although the majority of patients underwent reconstruction with flaps, our results showed that primary closure could be a viable option for certain patients with early-stage lesions.

Keywords

• reconstruction
• oral cancer
• primary closure
• free flap
• local flap