Case Reports of Two Unusual Donor Site Complications of the Pectoralis Major Myocutaneous Flap and Literature Review

Unilateral pectoralis major muscle flap for the treatment of sternal wounds due to Ludwig's angina

“…In addition to the common postoperative complications to any muscle flap, specifically in relation to the pectoralis major muscle flap for the treatment of sternotomy dehiscence, we found instability of the chest cavity and chronic pain. Complications at the donor area, such as pneumothorax and breast skin necrosis, have been described after the use of the pectoralis major myocutaneous flap for head and neck reconstruction· …”

“…In addition to the common postoperative complications to any muscle flap, specifically in relation to the pectoralis major muscle flap for the treatment of sternotomy dehiscence, we found instability of the chest cavity and chronic pain. Complications at the donor area, such as pneumothorax and breast skin necrosis, have been described after the use of the pectoralis major myocutaneous flap for head and neck reconstruction⋅ (16) A study published in 2011 reported the long-term complications in 19 patients after using the bilateral pectoralis major muscle flap for sternotomy closure. After a mean follow up of almost 6 years, more than half of these patients reported an unstable chest, two-thirds of them reported difficulty in daily activities, and 37% reported problems with dressing⋅ (17) In that same study, 32% of patients preferred an alternative treatment at the time of flap harvesting, to avoid chest instability, even if such treatment could delay the healing process.…”

Mandibular Sequela Noma: Metal Plate Repair Associated with a Submental Flap, about One Case

“…Loco-regional flaps were used [6] [7]. The pediculated musculocutaneous flap of the pectoralis major would provide a good volume of tissue, but its cutaneous texture is different from the skin of the face [10] [11]. It would also leave an unsightly scarring ransom at the donor site in this young girl and hinder her femininity in adulthood [12].…”

Anatomical versus functional motor points of selected upper body muscles

“…However, by splitting the muscle, the NEP and MP may be separated as well, resulting in extensive functional impairment . Whereas Chen and colleagues recommended determining the entry points of the artery and nerve for optimal shaping of the muscle flap before surgery, Kim et al . advocated a better anatomical understanding.…”

“…[39][40][41] However, by splitting the muscle, the NEP and MP may be separated as well, resulting in extensive functional impairment. 42,43 Whereas Chen and colleagues 44 recommended determining the entry points of the artery and nerve for optimal shaping of the muscle flap before surgery, Kim et al 45 advocated a better anatomical understanding. Knowledge about the relationship between NEP and MP may be helpful for future surgical interventions, and has been discussed in the context of graciloplasty.…”