Long-term outcomes and quantitative comparison of mucosal repair using skin grafting versus polyglycolic acid sheet application for cT1–2 oral cancer defect

Background Skin grafting and polyglycolic acid (PGA) sheet application are two established mucosal repair techniques for early-stage oral cancer defects, yet quantitative long-term comparative data are lacking.Aims and Objectives To compare long-term wound contracture and postoperative complications of two methods for cT1–2 oral cancer mucosal defects.Material and Methods In this retrospective cohort study, 53 patients who underwent mucosal repair with skin graft (n = 25) or PGA sheet (n = 28) were followed for long-term wound shrinkage (median, 40.0 months), graft failure/necrosis, postoperative bleeding, and tongue tethering.Results Wound area decreased to 25.0% (interquartile range [IQR], 15.5–36.3) of the initial defect in the skin graft group versus 12.6% (IQR, 9.2–17.9) in the PGA sheet group (p = 0.0019). Multivariable analysis identified PGA sheet application (p = 0.0015) and adjuvant radiation (p = 0.0056) as independent predictors of greater wound shrinkage. Postoperative bleeding (21.4% vs. 8.0%) and tongue tethering (32.1% vs. 8.0%, p = 0.043) were more frequent in the PGA sheet group.Conclusions and Significance Skin grafting offers superior long-term dimensional stability and fewer functional complications for cT1–2 oral cancer defects. PGA sheets may be preferred when operative time or donor-site morbidity is a priority, providing practical guidance for reconstructive planning.