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Pulmonary atelectasis after reconstruction with pectoralis major flaps
H Seikaly1, W M Kuzon, P J Gullane
1Department of Otolaryngology, University of Toronto, Ontario, Canada.
Archives of Otolaryngology--Head & Neck Surgery
|May 1, 1990
Summary
Pectoralis major myocutaneous flap reconstruction for head and neck defects frequently causes atelectasis. Larger flap skin paddles significantly increase the risk of major atelectasis post-surgery.
Area of Science:
- Thoracic Surgery
- Head and Neck Surgery
- Surgical Oncology
Background:
- Atelectasis is a common postoperative complication.
- Pectoralis major myocutaneous flaps are utilized for head and neck defect reconstruction.
- The incidence of atelectasis specifically after this procedure requires further investigation.
Purpose of the Study:
- To determine the incidence of atelectasis following pectoralis major myocutaneous flap reconstruction.
- To identify potential risk factors for atelectasis in this patient population.
Main Methods:
- Retrospective review of 44 patients undergoing head and neck reconstruction.
- Comparison between patients receiving pectoralis major myocutaneous flap reconstruction (n=24) and a control group (n=20).
- Postoperative chest roentgenograms were analyzed for atelectasis using preestablished criteria.
Main Results:
- A high incidence of postoperative atelectasis was observed in both groups (70% in flap group, 65% in control group).
- Patients with pectoralis major myocutaneous flaps and skin paddles >40 cm2 had a significantly higher rate of major atelectasis (60%) compared to controls (5%).
- A strong correlation was found between skin island area and atelectasis severity in the flap group.
Conclusions:
- Atelectasis is a frequent complication after pectoralis major myocutaneous flap reconstruction for head and neck defects.
- Larger skin paddle size is associated with increased atelectasis.
- Reduced chest wall compliance due to primary closure of large donor defects may contribute to atelectasis.