Comparative Analysis of Postoperative Complications Following Autologous Free Dermal Fat Grafting in Free Fibula Reconstructed Mandibular Gingivobuccal Complex SCC: A Retrospective Cohort Study

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This study aims to evaluate the impact of autologous free dermal fat grafting (FDFG) on postoperative complications and quality of life (QoL) in patients with squamous cell carcinoma (SCC) of the gingivobuccal complex. A total of 105 patients who underwent surgical resection with free fibula flap reconstruction for primary SCC of the mandibular gingivobuccal complex were included and divided into 2 groups based on whether they concurrently received FDFG. Outcomes, including complications, FDFG retention, and QoL, were analyzed using (IBM SPSS Statistics version 26.0; IBM Corp., Armonk, NY) and (R software version 4.3.1; The R Foundation for Statistical Computing, Vienna, Austria). Results showed that the FDFG group had a significantly lower incidence of plate exposure (7.7% versus 33.3%, P=0.002) and chronic pain (32.3% versus 57.9%, P=0.021) compared with the non-FDFG group. FDFG thickness retention at 6 months ranged from 60.9% to 73.9%. At 6 months postoperatively, the FDFG group demonstrated significantly better QoL scores for "pain" [4.2 (0-8.3) versus 12.5 (0-33.3), P=0.044] and "social contact" [0 (0-20.0) versus 13.3 (0-26.7), P=0.026], though these differences became nonsignificant by 9 months. In conclusion, performing FDFG concurrently with fibula flap reconstruction may be a feasible approach for mandibular gingivobuccal complex SCC, potentially reducing hardware exposure, improving short-term QoL, and achieving satisfactory graft survival and retention.

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