Objective To extract and summarize the best relevant evidence on flap microcirculation management for oral cancer patients during the postoperative ICU stay, thereby providing essential references for improving postoperative oral care. Methods The relevant literature on flap microcirculation management for postoperative oral cancer patients during the ICU transition period was systematically searched across clinical decision supporting systems, guidelines from both domestic and international sources, professional association websites, and related databases, including clinical decisions, guidelines, evidence summaries, systematic reviews, and expert consensus. Retrieval time limit was from the establishment of the database to December 26, 2025. Two researchers trained in evidence-based practice independently assessed the quality of the literature, extracted evidence, and summarized the findings. Results A total of 16 articles were included, comprising 1 clinical decision, 3 guidelines, 2 evidence summaries, 4 systematic reviews, and 6 pieces of expert consensus. Twenty-six best evidence statements were formulated and classified into four key areas: multidisciplinary team formation, microcirculation assessment and monitoring, microcirculation support management, and vascular crisis identification and management. Conclusion The summarized best evidence on flap microcirculation management for oral cancer patients during the postoperative ICU stay provides an evidence-based foundation to develop management protocols and guide clinical practice.