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(1) Background: The radial forearm flap (RFF) has evolved as the flap of choice for intraoral mucosal reconstructions, providing thin and pliable skin with a safe blood supply. Perforator flaps such as the anterolateral thigh (ALT) flap are increasingly being discussed for the same applications. (2) Methods: Patient history, treatment details, and outcome of 12 patents with moderate to extended defects of the lip and/or nose area that were reconstructed by a folded radial forearm flap were retrospectively evaluated for oncologic and functional outcomes. (3) Results: The mean oncologic and functional follow-up were 21.1 (min. 3.8; max. 83.3) and 31.2 (min. 6; max. 96) months, respectively. All flaps survived without revision. In eight cases, major lip defects were reconstructed by an RFF; in six patients, the palmaris longus tendon was included for lip suspension. The functional results in terms of eating, drinking, and mouth opening were good in five cases, while three patients were graded as fair due to moderate drooling. In seven cases, the major parts of the nose were reconstructed with two good and five fair (nostril constriction in three cases) functional results. (4) Conclusions: The folded RFF remains a unique free flap option for complex three-dimensional lip and nose reconstructions in terms of flexibility, versatility, and robustness. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to categorize the vitality and inflammation of resected bone of patients with medication‐related osteonecrosis of the jaw (MRONJ) and to correlate the grade of inflammation with the surgical success. Methods: This prospective study includes 44 patients with stage III MRONJ. Necrotic bone was resected in a block fashioned way. After demineralization and staining, histological analyses were performed by measuring the areas of necrotic, vital, and regenerative bone. Areas of chronic and acute inflammation were categorized as non, mild, moderate, and severe and were correlated with surgical success and parameters of inflammation in blood plasma (C‐reactive protein and leukocytes). Results: An average area of 59.0% was necrotic in the examined specimen. Vital bone was measured with an average area of 40.9%. The stage of chronic inflammation correlated with the amount of vital bone (P <.001) and the success of surgery (P =.002). If acute inflammation was dominant, chronic inflammation areas were found less while necrotic areas were observed more (P <.001). Also, the risk of relapses, wound healing disorders, and the level of C‐reactive protein were elevated if acute inflammation was severe or moderate (P =.031). Areas of bone regeneration were seen only in 11.3% of vital bone areas and occurred independently of infection stages. Conclusion: If possible, surgery should be delayed in patients with signs of severe acute inflammation. Patients may profit from prolonged pre‐operative antibiotic therapy to reduce the level of acute inflammation. [ABSTRACT FROM AUTHOR]