The vascular anatomy of the pectorals major myocutaneous flap

Freeman, Jacob; E, Walker; Wilson, J.S.P.; Shaw, H. J.

doi:10.1016/0007-1226(81)90086-2

Cited by 106 publications

(32 citation statements)

References 5 publications

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“…The surgical technique used to harvest the PMMF was as described in the literature, 7,10,18,23 and is depicted in Figure 1 (A-C). In most cases, the vascular pedicle was dissected under direct viewing, after making an incision in the chest skin from the upper border of the cutaneous paddle of the flap to the midclavicular line.…”

Section: Patients and Data Collectionmentioning

confidence: 99%

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

et al. 2010

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CONTEXT AND OBJECTIVE: Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection. DESIGN AND SETTING:Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC). METHODS:Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion.RESULTS: There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (P = 0.02) and with reconstruction failure (P < 0.001). Previous oncological treatment negatively influenced the reconstruction success (P = 0.04). CONCLUSIONS:Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.RESUMO CONTEXTO E OBJETIVO: Retalhos pediculados têm grande importância nos centros de tratamento do câncer, principalmente em países emergentes e em desenvolvimento. O objetivo deste trabalho foi identificar fatores que determinam complicações e influenciam no resultado final das reconstruções com retalho miocutâneo de peitoral maior (RMPM) no reparo de defeitos cirúrgicos por ressecções de cânceres de cabeça e pescoço. TIPO DE ESTUDO E LOCAL: Estudo transversal no Hospital de Ensino Padre Anchieta da Faculdade de Medicina do ABC.MÉTODOS: Dados de 58 pacientes submetidos a reconstruções de defeitos de cabeça e pescoço com RMPM foram revisados. O resultado final da reconstrução (sucesso ou falha) e as complicações observadas foram avaliados de acordo com a idade do paciente, área reconstruída, estágio da doença, tratamento oncológico prévio e necessidade de transfusão sanguínea.RESULTADOS: Não houve perda total de retalho. A taxa de sucesso da reconstrução foi de 93,1%. Complicações relacionadas ao retalho ocorreram em 43,1% dos casos e 50% delas foram considerados como complicações maiores. A maioria das complicações foi tratada com sucesso. Os defeitos originados da hipofaringe relacionaram-se com o desenvolvimento de complicações maiores (P = 0,02) e falhas na reconstrução (P < 0,001). Tratamento oncológico prévio influenciou negativamente no sucesso da reconstrução (P = 0,04).CONCLUSÕES: Como os fatores de risco...

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Section: Patients and Data Collectionmentioning

confidence: 99%

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

et al. 2010

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“…During recent years, the pma is frequently used in plas tic surgery and orthopedics as the material for musculocu taneous flaps in reconstructing the cervical and thoracic regions [11][12][13][14][15][16], According to these investigators, the clavi cular and sternocostal parts of the pma are supplied by the Ta and the internal thoracic artery, while the abdominal part of this muscle is supplied by the Tl. Concerning this artery for the abdominal part, we have previously reported [1.9, 17] that the Tl supplies the lower half of the pmi and the base of the muscular bundles of the serratus anterior muscle, as they arise from the third to fifth ribs, and then proceeds toward the anteromedial side to penetrate through each intercostal space to merge with the posterior intercostal artery.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Part Artery of Axillary Artery: Proposed Term for the Artery Supplying the Abdominal Part of the Musculus pectoralis major

Sato¹,

Takafuji²

1992

Cells Tissues Organs

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In 1976, the authors reported that the abdominal part artery (Pab) supplying the abdominal part of the pectoralis major muscle usually originates from the axillary artery (Ax). The findings in the present study show that the type of origin of this artery most frequently encountered is type 2-a (44.0%) in which the Pab, as an independent branch (type a), branches out of the second part of the Ax (type 2). The second and third most frequently encountered types are type 2-b (17.0%), where the Pab has a common trunk with the thoracoacromial artery, and type 2-c (10.0%), where it has a common trunk with the lateral thoracic artery. By classification according to the supplying areas, 67% was type I-B, supplying the lower part of the pectoralis minor muscle and the abdominal part of the muscle. In 5% the branch as type I-A courses down to the sternocostal part. In most cases (types A and B in 91%), this artery originates from the Ax proximal to the ansa mediana of the brachial plexus; however, in 4% providing the superficial brachial artery, the Pab branches out from the superficial brachial artery. Based on those findings, the authors would propose that the artery be named the arteria partis abdominalis or Pab.

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“…Baek et al(1982) was first to present clinical experience in a large series of cases including 133 flaps. Freeman et al (1981) described the vascular anatomy. In the early eighties PMF seemed to offer a definite advance in reconstructive surgery over previously employed methods.…”

Section: Introductionmentioning

confidence: 99%