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The aim of this report was to show applicability of \u201cthinned\u201d peroneal artery perforator (PAP) flaps in intraoral reconstruction. We report two cases of squamous cell carcinoma involving the tongue and floor of the mouth, where one patient had advanced scleroderma with tight forearm skin and the other with a history of Reynaud's disease precluding the use of RFFF. In addition, both patients were morbidly obese with thick adipose tissue in the thigh making ALT flap not a suitable option. Instead, a PAP flap was chosen. After the harvest, the subcutaneous tissue thickness was measured to be 2.2 and 1.8 cm, respectively. The thinning was performed by removing the deep fat lobules of the superficial fat layer down to a final thickness of 0.4 and 0.3 cm, respectively. A 2 \u00d7 2 cm area surrounding the perforators were kept untouched. Both patients had uneventful postoperative course with one patient having a small donor area dehiscence that healed with local wound care. The functional outcomes at 1 year were good. \u201cThinned\u201d PAP flap is a unique and novel application that may be an alternative in intraoral reconstruction when primary choices are not available. \u00a9 2014 Wiley Periodicals, Inc. Microsurgery 35:399\u2013402, 2015.<\/jats:p>","DOI":"10.1002\/micr.22366","type":"journal-article","created":{"date-parts":[[2014,12,20]],"date-time":"2014-12-20T13:35:56Z","timestamp":1419082556000},"page":"399-402","source":"Crossref","is-referenced-by-count":14,"title":["Intraoral reconstruction with \u201cthinned\u201d peroneal artery perforator flaps: An alternative to classic donor areas in comorbid patients"],"prefix":"10.1002","volume":"35","author":[{"given":"Tahsin O\u011fuz","family":"Acart\u00fcrk","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery University of Pittsburgh Medical Center Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s A.","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burns University Hospital of Getafe Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Ereso","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery University of Pittsburgh Medical Center Pittsburgh PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21284"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200206000-00007"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7216-0519-7.00037-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.20952"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22140"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000095936.56036.CD"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d180ac"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(93)90149-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1275485"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2010.11.018"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21885"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2011.642983"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2004.10.010"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(87)90197-4"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22015"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199604001-00016"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181cbfebc"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006789"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200102000-00012"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0020.2000.290408.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198409000-00013"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(89)90087-8"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/01.PRS.0000138810.14520.2B","article-title":"Clinical applications of free soleus and peroneal perforator flaps","volume":"115","author":"Kawamura K","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"e_1_2_7_25_1","first-page":"1621","article-title":"Free peroneal perforator\u2010based sural neurofasciocutaneous flaps for reconstruction of hand and forearm","volume":"122","author":"Cai PH","year":"2009","journal-title":"Chin Med J"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-939930"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0901-5027(05)80854-9"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0007-1226(97)90504-X"},{"key":"e_1_2_7_29_1","first-page":"47","article-title":"Reconstruction of the anterior floor of the mouth using a peroneal perforator free flap. 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