Comparison of Immediate Versus Delayed Flap Reconstruction in Oral Cancer

Background: Soft-tissue flap reconstruction is essential for restoring both anatomical structure and functional capabilities following extensive ablative surgery for oral cancer, such as oral squamous cell carcinoma. These procedures are often necessary due to the involvement of critical oral cavity structures, leading to disruption of speech, swallowing, and mastication, as well as impacting aesthetics and overall quality of life. The timing of reconstruction remains a subject of debate among clinicians; some advocate for immediate reconstruction—performed during the same surgical sessionas tumour excision—highlighting advantages such as working with unscarred tissues, reduced risk of infection, and earlier commencement of functional rehabilitation. Others prefer delayed reconstruction, carried out after a gap of at least 72 hours,to 2 weeks particularly in cases requiring confirmation of clear surgical margins through histopathological analysis, or in patients with unstable medical conditions who need optimisation prior to major reconstructive procedures. Each approach has its own benefits and limitations, influencing complication rates, functional recovery, hospital stay, and the timing of adjuvant therapy. Thus, determining the optimal timing for flap reconstruction is crucial for maximising both oncologic safety and patient outcomes.