Improved Skin Paddle Survival in Pectoralis Major Myocutaneous Flap Reconstruction of Head and Neck Defects

2009 ◽  
Vol 11 (5) ◽  
pp. 306 ◽  
Author(s):  
Vijay R. Ramakrishnan ◽  
William Yao ◽  
John P. Campana
Keyword(s):  
Head And Neck ◽  
Myocutaneous Flap ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Flap Reconstruction ◽  
Skin Paddle

COMPLEX OROFACIAL DEFECTS -A RECONSTRUCTIVE CHALLENGE

2013 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Rajay A. D. Kamath ◽  
Shiva Bharani K. S. N. ◽  
S Shubha Lakshmi ◽  
Amith Hadhimane
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Myocutaneous Flap ◽  
Donor Site ◽  
Primary Objective ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Microvascular Reconstruction ◽  
Skin Paddle ◽  
Ablative Surgery

ABSTRACT Introduction Oral cavity cancers account for 30% of head and neck cancers and represent a significant challenge to clinicians. Treatment requires multi disciplinary expertise and is complicated by. the complex role that the oral cavity plays in speech, mastication, and swallowing. Surgery remains the cornerstone of most treatment regimens; the primary objective is cure, not withstanding preservation of form and function to retain a good quality of life that can be further improved by reconstructive techniques using various local flaps, distant flaps or microvascular reconstruction. The pectoralis major [PM] flap has many advantages in that it is very reliable, and allows a single-stage reconstruction of most head and neckdefects to the level of the maxilla with well-vascularized tissue capable of carrying a large skin paddle. The donor site morbidity is surprisingly low, and few patients complain of difficulties with arm movement. Aims & Objectives This paper revisits the surgical anatomy and technique of harvesting the Pectoralis Major myocutaneous flap used to reconstruct complex defects of the lower face following composite therapeutic resection. In addition, we describe our experience using this flap and discuss associated merits and demerits and complications. Conclusion Despite contemporary micro vascular techniques, the Pectoralis Major myocutaneous flap continues to be a versatile option in the reconstruction of complex head and neck defects following ablative surgery. However, regardless of the site, stage and degree of tumor differentiation, such cases will always pose as a therapeutic challenge to the reconstructive surgeon.

scholarly journals Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christiana Maria Ribeiro Salles Vanni ◽  
Leandro Luongo de Matos ◽  
Mário Paulo Faro Junior ◽  
Jossi Ledo Kanda ◽  
Cláudio Roberto Cernea ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Myocutaneous Flap ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Cross Sectional ◽  
Oncological Treatment ◽  
Major Complications

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications.Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction.Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria.Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx () as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (). The former condition is also associated with major reconstruction failure (). An even lower incidence of major complications was noted in patients under the age of 53 ().Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

Reconstructive Versatility of the Pectoralis Major Myocutaneous Flap

1980 ◽  
Vol 88 (4) ◽  
pp. 368-372 ◽  
Author(s):  
Victor V. Strelzow ◽  
Frederick Finseth ◽  
Willard E. Fee
Keyword(s):  
Myocutaneous Flap ◽  
Muscle Flap ◽  
Clinical Applications ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Vascular Pedicle ◽  
Skin Paddle ◽  
Advantages And Disadvantages ◽  
Lateral Muscle ◽  
Deltopectoral Flap

The pectoralis major myocutaneous flap is presented in its two basic forms: a muscle flap carrying a skin paddle and the continuous skin-muscle flap technique. The pertinent anatomy of the enveloping fascial planes is reviewed, stressing the increased latitude of safety afforded by elevating the vascular pedicle from the undersurface of the lateral muscle edge. The advantages of a deltopectoral flap outline in approaching the formation of the skin-muscle paddle are introduced. Clinical applications, advantages, and disadvantages are discussed.

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