Objective: To compare the application of medial sural artery perforator flap, lateral arm flap, anterolateral thigh flap and forearm flap in reconstruction of defects in the tongue and floor of mouth following ablative oncological surgery.

Methods: The study included 64 patients (39 male, 25 female, mean ages 57.3, and range 38 C71 years). 9 medial sural artery perforator flaps, 19 lateral arm flaps, 13 anterolateral thigh flaps and 23 forearm flaps were harvested. Flap sizes ranging from 5.6 to 8.11 cm.

Results: 60 (93.75%) flaps healed without venous insufficiency.

Conclusions: Each flap has its own advantage. Compared with the radial artery, the medial sural artery, posterior radial collateral artery, and descending branch of the lateral circumflex femoral artery is a nonessential vessel. Medial sural artery perforator flap, lateral arm flap and anterolateral thigh flap have the advantages including anatomically reliable vascular supply; accessible donor site; and the aesthetic quality of donor tissue; primary closure can be achieved in most patients. The disadvantages of lateral arm flap and anterolateral thigh flap are the relatively smaller vessel size and thicker subcutaneous tissue, while for medial sural artery flap, the thickness and volume can be adjusted to accommodate the extent of the defect.