Microscopic and immunohistochemical analysis of the skin changes of free forearm flaps in intraoral reconstruction

In the literature, few studies based on clinical and histological
evaluation analyze skin structural changes after transplantation to
the oral cavity. Ten patients affected by squamous cell carcinoma
of the oral cavity who were reconstructed with a free forearm flap
were included in the current study to analyze skin alterations. The
authors performed a histological and ultrastructural evaluation of
skin samples from the free forearm flap before transplantation
and 18 months after intraoral reconstruction. They analyzed
cytokeratin and involucrin distribution, which represent markers
of maturation and differentiation of epithelia. The aim of this
study was to demonstrate whether skin “mucosalization” occurs.
They found that the skin undergoes some morphological changes
induced by the intraoral environment. Cytokeratin and involucrin
distribution is mostly unchanged. This aspect is in favor of skin
structure preservation. Thus, they found that “mucosalization” of
the skin is not evident after 18 months.