Abstract
A 75-year-old Asian man presented with Notani Grade 3 osteoradionecrosis of the right mandible with an orocutaneous fistula. He underwent ablative resection with fibular free flap and pectoralis major myocutaneous flap reconstruction. Unfortunately, the neck wound dehisced with purulent discharge from the mandible. Initial management involved antibiotic therapy, debridement, and wound dressings. Further breakdown ensued, exposing the bone and mandibular reconstruction plate (Fig. 1). We debrided the wound, sectioned the exposed plate at the wound edges, and covered with an Integra® dermal regeneration template and a sponge bolster dressing, which was unsuccessful.
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