{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:09:46Z","timestamp":1790258986702,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,8]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Surgery for oral malignancies is usually followed by reconstruction of the defect. Free flaps remain the ideal choice for reconstruction, but advocating for it may not be possible in all circumstances. The submental artery-based island flap (SMIF) is a well-known local flap for its high reliability, versatility and arc of rotation; however, venous congestion is a major reason for its failure.<\/jats:p>\n                  <jats:p>A 50-year-old man underwent surgery for carcinoma gingivobuccal sulcus, which involved reconstruction of the oral defect with SMIF. The flap developed venous congestion 17 hours following surgery. The flap was immediately re-explored and could be salvaged. There was no flap loss or recipient\/donor site morbidities during follow-up.<\/jats:p>\n                  <jats:p>Immediate re-exploration of the submental flap, undergoing venous congestion, can prevent a flap loss. Close monitoring for flap changes is mandatory in the immediate postoperative period for SMIF, especially for those with altered venous drainage.<\/jats:p>","DOI":"10.1136\/bcr-2024-261716","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:55:29Z","timestamp":1790258129000},"page":"e261716","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Salvaging a submental flap"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4750-8111","authenticated-orcid":false,"given":"Jeyashanth","family":"Riju","sequence":"first","affiliation":[{"name":"Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natarajan","family":"Ramalingam","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4087-1743","authenticated-orcid":false,"given":"Jino Johns","family":"Lalitha","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glynis Florence","family":"Francis","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"2026092406552219000_19.9.e261716.1","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1007\/s13193-025-02264-1","article-title":"Prevalence, Incidence, and Mortality Trends of Head and Neck Cancers in India: A GLOBOCAN 2022 Statistics Analysis","volume":"16","author":"Goyal","year":"2025","journal-title":"Indian J Surg Oncol"},{"key":"2026092406552219000_19.9.e261716.2","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s13193-016-0532-2","article-title":"Oncological Safety of Submental Artery Island Flap in Oral Reconstruction - Analysis of 229 Cases","volume":"7","author":"Thomas","year":"2016","journal-title":"Indian J Surg Oncol"},{"key":"2026092406552219000_19.9.e261716.3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.joms.2019.08.028","article-title":"Modified Submental Island Flap for the Surgical Treatment of 4 Patients With Stage 3 Medication-Related Osteonecrosis of the Mandible","volume":"78","author":"Myoken","year":"2020","journal-title":"J Oral Maxillofac Surg"},{"key":"2026092406552219000_19.9.e261716.4","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/jso.26125","article-title":"Submental flap: Game changer in oral cancer reconstruction-A study of 1169 cases","volume":"122","author":"Pradhan","year":"2020","journal-title":"J Surg Oncol"},{"key":"2026092406552219000_19.9.e261716.5","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199392050-00013"},{"key":"2026092406552219000_19.9.e261716.6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0007-1226(96)90078-8","article-title":"The submental island flap","volume":"49","author":"Sterne","year":"1996","journal-title":"Br J Plast Surg"},{"key":"2026092406552219000_19.9.e261716.7","doi-asserted-by":"crossref","first-page":"101789","DOI":"10.1016\/j.jormas.2024.101789","article-title":"Submental island flap versus supraclavicular island flap in oral tongue cancer reconstruction: Perioperative and functional outcomes","volume":"125","author":"Klibngern","year":"2024","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"2026092406552219000_19.9.e261716.8","doi-asserted-by":"crossref","first-page":"106539","DOI":"10.1016\/j.oraloncology.2023.106539","article-title":"Submental artery island flap in malignancy of tongue. A reconstructive Dilemma!","volume":"145","author":"Tazeen","year":"2023","journal-title":"Oral Oncol"},{"key":"2026092406552219000_19.9.e261716.9","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.bjoms.2016.10.022","article-title":"Submental island flap reconstruction in oral cavity cancer patients with level I lymph node metastasis","volume":"55","author":"Sittitrai","year":"2017","journal-title":"Br J Oral Maxillofac Surg"},{"key":"2026092406552219000_19.9.e261716.10","first-page":"S1","article-title":"The submental flap for head and neck reconstruction: Comparison of outcomes to the radial forearm free flap","volume":"130 Suppl 2","author":"Patel","year":"2020","journal-title":"Laryngoscope"},{"key":"2026092406552219000_19.9.e261716.11","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1002\/jso.24336","article-title":"Surgical anatomy of the vascularized submental lymph node flap: Anatomic study of correlation of submental artery perforators and quantity of submental lymph node","volume":"115","author":"Tzou","year":"2017","journal-title":"J Surg Oncol"},{"key":"2026092406552219000_19.9.e261716.12","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1055\/s-0040-1721766","article-title":"Flap Failure and Salvage in Head and Neck Reconstruction","volume":"34","author":"Wang","year":"2020","journal-title":"Semin Plast Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261716","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:55:40Z","timestamp":1790258140000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":12,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,24]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2024-261716"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261716","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}