P21 / British Journal of Oral and Maxillofacial Surgery 52 (2014) e75–e127 e103

and custom made PEEK implant to reconstruct the temporalfossa, lateral orbital wall and zygoma. In addition we reviewthe literature on temporal and infratemporal recurrence ofmandibular ameloblastoma.

http://dx.doi.org/10.1016/j.bjoms.2014.07.180

P79

Non-Cultured Autologous Cellular Spray To ImproveColour Matching For Distant Tissue Reconstruction

Mark Ansell ∗, Colin MacIver

Ninewells Hospital

Introduction: Reconstruction of the head and neck usingpedicled or free flaps is now common practice and while formand function can be restored, often the skin colour and tex-ture match can be disappointing. Reconstruction using localflaps can improve aesthetics but is limited in quantity andincreases local morbidity, while distant tissues can result incolour and texture mismatch. Skin grafting of the skin paddleis a conventional approach that can be used to overcome thisproblem, but with risk of morbidity at a second donor site isa less predictable outcome.

Methods: A case series of trauma and oncology patientsthat have undergone free flap reconstruction of the head andneck are presented. They have been treated using Dermabra-sion and Recell autologous cellular spray to improve thecolour and texture of the transplanted tissue. The techniqueof skin preparation, graft harvesting, processing, applicationand follow up are described in detail.

Results: All patients demonstrated a significant improve-ment in skin colour and texture. Staff training was identifiedas the only problematic issue relating to the procedure. Costanalyses show that the technique is more cost effective thanalternative techniques.

Conclusion: Non-cultured autologous cellular spray forimprovement of the aesthetics of free flap reconstructionsoffers an improved, cost effective and predictable alternativeto conventional techniques. Morbidity is minimal and can becarried out in a day case setting.

http://dx.doi.org/10.1016/j.bjoms.2014.07.181

P80

Reconstructive options for a subtotal upper lip oncologi-cal resection for an invading SCC

Anthony Greenstein ∗, T. Lowe, E.L. Ford

Aberdeen Royal Infirmary

Aim: To review surgical options for reconstruction of largeupper lip defects following oncologic resection and proposea reconstructive algorithm for these challenging cases.

IntroductionSCC of the lip represents an annual incidence of 0.3 per

100,000 of all Head and neck malignancy. The lower lip ismost commonly affected, with the the upper lip and com-misure involved less frequent. There are many challengesinvolving reconstruction of large upper lip defects and variouslocal, regional and free flap options are available. This posterhighlights the importance of careful planning and judiciousconsideration of the surgical options available to maximiseform and function in the resulting lip reconstruction followingoncologic resection.

Methods: An 80 year old man presented with a largeexophytic SCC invading most of his upper lip. Treatmentplanning involved resection with 1 cm macroscopic margins.His comorbidities precluded the use of a free flap reconstruc-tion so local flap options were considered. This poster willreview current algorithms/designs, highlighting the advan-tages and disadvantages of the flap designs available for thereconstruction of the upper lip.

Results: In this case, the reconstruction of the upper lipwas successfully achieved using a reverse Karapanzic flap.Postoperative recovery was uneventful and he was able toform a functional oral seal in the immediate postoperativeperiod.

Conclusions: Large upper lip defects pose many chal-lenges in terms of functional reconstruction that set it apartfrom the lower lip. This poster reviews surgical optionsavailable to optimise reconstructive outcome following largevolume upper lip resection.

http://dx.doi.org/10.1016/j.bjoms.2014.07.182

P81

Treatment of large skin defects of the head by vacuum-assisted wound dressing

Florian Bast ∗, Christopher Abela, Jonathan Collier

Chelsea and Westminster Hospital

Introduction: Large skin defects over the forehead andscalp that are down to bone are often significant recons-tructive challenges. Lack of local tissue elasticity precludesclosure with simple flaps while multi-stage tissue expansionor free tissue transfer may be limited by patient co-morbidityand age. Grafting on to bare bone must be preceeded by pro-cedures to stimulate granulation tissue, usually by drilling ofthe outer table.

VAC-assisted wound closure is well established in themanagment of complex or chronic wounds. However, its useprior to scalp grafting has not been well described. The aimof this presentation is to describe our experience of using thistechnique.

Material and Methods: A large scalp BCC on a 83-yearold male patient required excision down to bone for clearance.The VAC system (KCI) was applied to the resulting defectwith a diameter of 10 cm.