Major head and neck reconstruction using the deltopectoral flap

Gilas, Tom; Sako, Kumao; Razack, Mohamed S.; Bakamjian, Vahram Y.; Shedd, Donald P.; Calamel, Peter M.

doi:10.1016/0002-9610(86)90318-1

Cited by 43 publications

(26 citation statements)

References 17 publications

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“…This is particularly relevant for a 'walking' flap, which may require several surgeries spaced out over months (12). Many authors have reported flap success rates in the range of 75% to 90%, with failures typically including distal flap necrosis (12,16,19,20). With meticulous flap handling and careful attention to the fascial plane during dissection, the deltopectoral flap has the potential for rates of success of 90% to 95%, comparable with those of free flaps (16).…”

Section: Discussionmentioning

confidence: 99%

“…With meticulous flap handling and careful attention to the fascial plane during dissection, the deltopectoral flap has the potential for rates of success of 90% to 95%, comparable with those of free flaps (16). One suggestion is to avoid tubing the pedicle base, thereby removing potential limitation on blood flow in the event of postoperative swelling (15,20). Feng et al (15) reported 34 cases using the extended deltopectoral flap with no flap loss, and in which only two cases required local advancement of skin or skin grafting to complete the closure, yielding a success rate >94%.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, this promotes vascular reorganization in the distal extent of the flap overlying the deltoid, which should improve survival. In practice, it has yielded somewhat mixed results, ranging from 84% to 100% success (12,20). In a large review of 678 deltopectoral flaps, 125 of which were delayed, Gilas et al (20) concluded that delay did not yield a significant change in rate of complications or major necrosis when compared with a regular dissection.…”

Section: Discussionmentioning

confidence: 99%

“…In practice, it has yielded somewhat mixed results, ranging from 84% to 100% success (12,20). In a large review of 678 deltopectoral flaps, 125 of which were delayed, Gilas et al (20) concluded that delay did not yield a significant change in rate of complications or major necrosis when compared with a regular dissection. Hence the 'delay' operation seems inadvisable, especially because the delay step is itself associated with flap necrosis in a small number of cases.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer

et al. 2012

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“…Many authors have reported flap success rates in the range of 75% to 90%, with failures typically including distal flap necrosis. [4] With meticulous flap handling and careful attention to the fascial plane during dissection, the deltopectoral flap has the potential for rates of success of 90% to 95%.…”

Section: Case Historymentioning

confidence: 99%

Caterpillar Advancement for Partially Necrosed Deltopectoral Flap

Gautam¹,

Khobragade²,

Kumar³

2015

jemds

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Development of electric lamp by Thomas Elva Edison had significant impact on human civilization. With increasing production of electrical energy to meet ongoing demands of increased frequency of electrical injuries. Despite increased awareness of potential dangers, electricity is responsible for many fatalities all over the world. Electrical burn accounts for ~3% of all burn related injuries. Estimated 3, 000 annual admittions to burn units. Electrical burn have bimodal distribution ~1/3 children <6 yrs (Electric cords & wall outlets) ~2/3 miners, construction, & electrical workers. Our case is one that of a 12 year old male child having electrical injury over face and neck with exposed angle of mandible which was covered by Deltopectoral flap with caterpillar advancement of flap. KEYWORDS: Electrical burn, Flap Necrosis, Flap Divison, Deltopectoral flap with caterpillar advancement. INTRODUCTION:Deltopectoral flap is a fasciocutaneous type of flap. Standard Flap size of 10 X20 cm and Delayed flap size of 10 X 27cm. Sensory nerve supply is from second to fourth intercostal nerve. Dominant pedicle of flap is largely based on first, second and perforating branches of internal mammary artery. Standard flap will reach neck, lower face and oral cavity but delayed flap has a longer reach and may be folded for intra-oral reconstruction or for an extended arc of rotation to the midface. For standard flap, it is located b/w sternum and anterior axillary line and extends from clavicle to 4 th or 5 thc IC space. For extended flap, it is extended over deltoid muscle. A preliminary flap delay is required to extend flap length. The donor site is rather obvious and almost always requires a skin graft for closure.

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The Cervicodeltopectoral Flap for Single-Stage Resurfacing of Anterolateral Defects of the Face and Neck

Ducic

Smith

2003

Archives of Facial Plastic Surgery

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To evaluate prospectively the feasibility and utility of adding a cervical extension to the standard deltopectoral flap. We postulated that this cervicodeltopectoral (CDP) flap will allow for single-stage reconstruction of large defects of the anterolateral face and neck.Methods: As is the case with the deltopectoral flap, the CDP flap is based on the perforating branches of the internal mammary artery. However, the superior and posterior limbs of the CDP flap are not limited by the clavicle and the deltoid muscle. Instead, they extend in a subcutaneous tissue plane to the margins of the neck or facial defect and transfer the entire intervening skin bridge with the deltopectoral flap.Results: Eighteen patients underwent closure of complex cutaneous defects of the face and neck with the CDP flap. We found no evidence of flap loss in any of these patients. Twelve patients had received preoperative radiation therapy encompassing the cervical extension of the CDP flap. No evidence of adverse healing was noted in this subset of patients. Conclusions:The CDP flap may represent an alternative in the surgical treatment of various cutaneous defects of the face and neck. It allows for single-stage, reliable reconstruction of these defects. The transfer of intervening cervical skin in conjunction with the deltopectoral flap provides for a more aesthetically pleasing reconstruction, as skin immediately adjacent to the defect is more closely related to the excised skin in terms of color and texture.

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Major head and neck reconstruction using the deltopectoral flap

Cited by 43 publications

References 17 publications

Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer

Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer

Caterpillar Advancement for Partially Necrosed Deltopectoral Flap

The Cervicodeltopectoral Flap for Single-Stage Resurfacing of Anterolateral Defects of the Face and Neck

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