Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

Zbar, Ross I. S.; Funk, Gerry F.; McCulloch, Timothy M.; Graham, Scott M.; Hoffman, Henry T.

doi:10.1002/(sici)1097-0347(199708)19:5<412::aid-hed8>3.0.co;2-2

Cited by 76 publications

(48 citation statements)

References 20 publications

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“…4,9 Even at head and neck surgery services in which free flaps are used, the pectoralis major and other myocutaneous flaps can be performed in combination with free flaps to reconstruct larger defects, to protect important vessels at risk for complications, and to treat or prevent complications of wound breakdown. 10 These data reinforce the concept that myocutaneous flaps are a valuable tool in head and neck cancer surgery.…”

supporting

confidence: 68%

“…10 Also it can be used as a salvage procedure after the necrosis of microvascularized flaps and in cases in which a contraindication to free flaps exists, such as a medical condition that makes the patient unable to tolerate a long surgical procedure or inadequate recipient vessels in the necks of patients who previously underwent high-dose radiotherapy. A reported disadvantage of the pectoralis major flap is related to the poor vascular supply to the distal skin paddle, which can cause partial dehiscence (mostly at the distal portion of the flap), fistulization, and infection, resulting in a prolonged hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…A reported disadvantage of the pectoralis major flap is related to the poor vascular supply to the distal skin paddle, which can cause partial dehiscence (mostly at the distal portion of the flap), fistulization, and infection, resulting in a prolonged hospital stay. 10 Regarding the technical aspects involved, in most patients we performed an island flap with a low skin incision at the donor site and we transferred the flap through a subclavicular tunnel to the head and neck region. These modifications had been previously described by Azevedo,11,14 who emphasized that an island flap partially preserves the pectoralis major muscle, decreasing the functional impairment of the arm, and the flap transference to the head and neck region by a subclavicular tunnel increases the flap rotational arc.…”

Section: Discussionmentioning

confidence: 99%

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Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution

et al. 2004

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Background. Pectoralis major and other myofascial/myocutaneous flaps have been recognized as important reconstructive methods in head and neck cancer surgery. Even with the worldwide use of free flaps, they are still the mainstay reconstructive procedures in many centers.Methods. We retrospectively analyzed the records of patients with head and neck cancer who underwent an immediate reconstruction with pectoralis major or other myofascial/myocutaneous flaps at a tertiary cancer center from 1982 to 1998.Results. A total of 437 patients were reviewed. Three hundred seventy-one patients underwent pectoralis major myocutaneous flaps; of these, 335 (90.3%) were men, with a median age of 56 years (range, 24 -91 years). Tumors were located at the oral cavity and oropharynx in 246 patients (66.3%). Most tumors were at an advanced stage at presentation (T3 -T4 in 60.9%). The flaps were used to cover mucosal defects in 280 patients (75.5%), skin defects in 62 patients (16.7%), and both in 29 patients (7.8%). In most patients, the flap was transferred to the head and neck region through a subclavicular tunnel. The overall complication rate was 36.1%, with 2.4% of cases involving total flap necrosis. Conclusion.To date, this is the largest published series of patients who underwent reconstruction with a pectoralis major flap. Our results show that this flap remains an important reconstructive method, and it can be done with low risk and acceptable morbidity.

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supporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution

et al. 2004

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“…In all other patients, reconstructions with primary PMMC flaps were successful, with the reconstruction success rate being 83%. These results are slightly lower than success rates of other studies, which ranged from 87.5% to 100% [13,[15][16][17].…”

Section: Discussioncontrasting

confidence: 67%

Indications and Outcomes for Pedicled Pectoralis Major Myocutaneous Flaps at a Primary Microvascular Head and Neck Reconstructive Center

Saito¹,

Minakawa²,

Saito³

et al. 2012

MPS

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The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evolved and recently free tissue transfer has played an important role in head and neck reconstruction. Although we use free flaps as the first choice for head and neck reconstruction, similar to many other institutions, some patients at our hospital have undergone reconstruction with PMMC flaps. We retrospectively analyzed the indications and outcomes of this reconstructive technique from our experience with 12 patients. The medical records of all patients who underwent PMMC flaps at Hokkaido Cancer Center from 2001 to 2010 were reviewed. Data concerning diagnosis, main indication, site of reconstruction, previous treatment, and postoperative complications were analyzed. Of the 12 PMMC flap surgeries performed, 3 were carried out as primary reconstructive procedures, whereas 9 were done as "salvage" procedures. Flap-related complications were observed in 6 cases. Partial flap loss developed in 4 patients, although there were no cases of total flap loss. There were 3 recurrent fistulae following reconstruction with PMMC flaps. The preoperative goals of performing PMMC flap surgery were met in 83% of our cases. The authors conclude that while free flap transfer is usually the first choice for head and neck reconstruction, PMMC flaps can produce acceptable results in certain situations.

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“…Among the cases that developed some kind of flap necrosis, we tried to identify possible technical causes that could be correlated with this. Unrelated complications were considered separately [15][16][17][18][19][20][21][22][23][24][25].…”

Section: Metarial and Methodsmentioning

confidence: 99%

BipaddlePectoralis Major Myocutaneous Flap for oral cancer reconstruction: Operative technique, flap reliability and outcome, Asingle Institute experience.

Jain¹,

Singh²,

M.S³

2016

IOSR

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Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

Cited by 76 publications

References 20 publications

Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution

Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution

Indications and Outcomes for Pedicled Pectoralis Major Myocutaneous Flaps at a Primary Microvascular Head and Neck Reconstructive Center

BipaddlePectoralis Major Myocutaneous Flap for oral cancer reconstruction: Operative technique, flap reliability and outcome, Asingle Institute experience.

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