The Rib-Pectoralis Major Osteomyocutaneous Flap

Bell, Muyinatu A. Lediju; Barron, Philip

doi:10.1097/00000637-198105000-00002

Cited by 32 publications

(14 citation statements)

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“…Bell & Barron [2] reported firm bony union in 14 patients at pin removal three months postoperatively. Bone biopsies taken in two patients at four and 12 postoperative weeks revealed viable, architecturally normal bone.…”

Section: Discussionmentioning

confidence: 98%

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Complications of the pectoralis major osteomyocutaneous flap used for head and neck reconstruction

et al. 1996

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The analysis of the complications of the pectoralis major osteomyocutaneous flaps used for head and neck reconstruction and how to prevent them is the subject of this report. Ten patients with squamous cell carcinoma of the floor of the mouth who had undergone segmental glossectomy and mandibulectomy, radical uni-or bilateral cervical lymphadenectomy, and immediate reconstruction with the pectoralis major osteomyocutaneous flaps were evaluated. Neither partial nor total necrosis of the myocutaneous segment occurred in any patient but rib necrosis developed in five. An oral fistula occurred in four patients exposing the junction of the rib with the mandible. There were three cases of flap necrosis of the neck dissection. Two patients developed pneumothorax. The overall complication rate was 66.7%. Although this surgery requires major intraoral excision, the tumor is exophytic with previous infection and the patients' general condition debilitated, the incidence of complications is high. Despite the high morbidity, the pectoralis major myocutaneous flap remains a useful adjunct for head and neck reconstruction. The flap is versatile and for many patients repair with a free flap is impossible because of contraindications such as previous irradiation, problems with the vascular anastomoses, advanced age and poor general condition. It also aids in the surgical training of new specialists.

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Section: Discussionmentioning

confidence: 98%

“…gether with the fifth or sixth rib [4], Bell & Barron [2] for segmental reconstruction of the mandible. Currently, for head and neck reconstruction, many other flaps including free flaps are available.…”

mentioning

confidence: 99%

Complications of the pectoralis major osteomyocutaneous flap used for head and neck reconstruction

et al. 1996

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“…4,6,9,13,[15][16][17][18][19][20][21][22] The ideal composite graft provides a long reliable vascular pedicle, rigid well-perfused cortical bone, muscle cover, ease of monitoring, and minimal donor site morbidity.…”

Section: Discussionmentioning

confidence: 99%

The Fibula-Flexor Hallucis Longus Osteomuscular Flap

Ruch

Koman

1997

The Journal of Bone and Joint Surgery. British volume

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Limb salvage after loss of bone and soft tissue may require many operations to obtain soft-tissue cover and bony continuity. We describe a fibula-flexor hallucis longus osteomuscular flap which can provide both soft tissue and bone in a single stage. The flap is based on the peroneal vessels and is covered by a split-thickness skin graft.We report the results in five patients with an average bone defect of 8.3 cm and soft-tissue and skin loss. All regained a normal gait on the donor side; four had clinical and radiological union with excellent soft-tissue cover, but one required later amputation due to diffuse coagulopathy.The flap provides free vascularised bone with muscle cover. It has a dependable, long pedicle with minimal morbidity at the donor site, and allows monitoring of the vascularity of the fibular graft. The use of vascularised bone grafts is well recognised.

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“…The local pedicled flaps have some disadvantages, e.g. significant drop and limitation of the movements of the shoulder joint [16], and persistent pleural effusion after the use of the rib [32]. In addition, there is rarely enough bone for dental implants or prosthesis [33].…”

Section: Discussionmentioning

confidence: 99%