PMC

CONSORT diagram for the trial. *Did not undergo colorectal resection (7 patients), participating in another trial (1), had been operated on as an emergency (1), or deemed unsuitable based on intraoperative problems and subsequent intensive therapy unit admission (1). †On at least one occasion according to chewing gum log. ‡Chewing gum log showed that: gum had been received but there was no information on whether or not it had been chewed (4); gum had not been received (4, 1 of whom had not been given gum in error); no information on whether or not gum had been received or chewed (15). §Chewing gum provided in error. ¶Questionnaire on use of gum in standard care group indicated that gum had been chewed at least once during days 1–5 after surgery

Reconstruction of the mandible using a scapular flap. A: Segmental resection of the mandible. The portion between arrowheads was resected. B: Specimen following the resection of invasive squamous cell carcinoma of the right gum. C: Scapular flap based on the subscapular artery, showing the latissimus dorsi with the thoracodorsal artery (open arrowhead) and the scapula portion of the flap with circumflex scapular artery (closed arrowhead). D: Reconstruction of mandible using scapular flap.

SMD + acupun, simo decoction with acupuncture. *Number of participants who received the allocated intervention. †Withdrawn by investigators before treatment began, because they did not undergo colorectal resection (n = 8), underwent emergency surgery (2), or remained in the intensive care unit for more than 24 h and so could not receive SMD or chewing gum (7). ‡Postoperative pathology revealed benign tumors (n = 8).

Tools for surgical operation and muscle isolation/fixation
(A) Photograph of the surgery equipment needed for tenotomy.
(B) Photograph of the kneaded tragacanth gum packed in a syringe.
(C) Photos of the original and cut cork.
(D) Photograph of the surgery equipment for plantaris muscle resection.