The Pectoralis Major Myocutaneous Flap

Abstract

In the era of free tissue transfer, the PMMF still has its advantages and continues to command an important place in the reconstructive surgeon's armamentarium.

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

“…The main reason has been the greater rate of complications associated with the PMMF compared with that of the MFTF, 16,17 resulting in longer hospital stays 3 and greater financial burden. [5][6][7]18 However, it is still useful as a salvage flap in the case of free-flap failures 4,5,8,17 and might be the best option when using the MFTF is not possible (eg, medical comorbidities, hypercoagulable states, lack of recipient vessels, and limited resources or microsurgical specialists in developing countries). 4,7,10,19 Moreover, the large bulk of intervening muscle is useful for covering the great vessels in the neck in the case of radical neck dissection 7,9,14 and for preventing pharyngocutaneous fistula in case of laryngopharyngectomies.…”

“…The pectoralis muscle is divided into 2 parts, which are responsible for different actions. 8 The clavicular part contributes to flexion, horizontal adduction, and inward rotation of the humerus. The sternocostal part contributes to downward and forward movement of the arm and inward rotation when accompanied by adduction.…”

“…In female patients, surgeons commonly use inframammary crease incisions to harvest the PMMF to minimize breast deformity. 8 The area of duskiness expanded on postoperative days 3 and 4, along with areas of epidermolysis on the breast tissue ( Fig 10). The skin of the breast had delayed capillary refill (>7 seconds), and the Jackson-Pratt suction drain started to express purulent discharge.…”

Resection and reconstruction of giant cervical metastatic cancer using a pectoralis major muscular flap transfer: A prospective study of 16 patients

“…After completing a radical neck dissection, a suitable flap must be obtained for the reconstruction of the affected region. The pectoralis major myocutaneous flap includes a large quantity of tissue; thus, this flap can adequately repair defects in cervical tissue caused by radical neck dissection, and this flap may therefore be utilized for a complete reconstruction that addresses these defects (8)(9)(10). In addition, this flap has a rich blood supply, exhibits strong resistance to infection and necrosis, and heals rapidly.…”

“…Thus, the use of this flap does not delay post-operative chemoradiotherapy or raise concerns regarding the exposure of the carotid artery due to post-operative flap necrosis. Therefore, the flap meets the clinical requirements for the treatment of patients with cervical metastatic cancer involving an unknown primary tumor (8)(9)(10). The present study examined the feasibility and efficacy of radical neck dissection combined with reconstruction using the pectoralis major myocutaneous flap for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin.…”