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Pectoralis major myocutaneous flap--still a workhorse for maxillofacial reconstruction in developing countries
Kiran Shrikrishna Gadre1, Pushkar Gadre, Vikrant Dilip Sane
1Consultant Maxillofacial Surgeon, Ruby Hall Clinic; Professor, Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth University Dental College and Hospital, Katraj, Pune, Maharashtra, India.
Purpose:
To retrospectively evaluate the utility of the pectoralis major myocutaneous (PMMC) flap for head, face, and neck (HFN) reconstruction in the Indian population.
Materials And Methods:
The hospital records of 496 patients in whom the PMMC flap was used (saving the deltopectoral flap) for reconstruction of HFN defects from January 1991 to December 2010 were reviewed retrospectively. All the patients were followed up for a minimum period of 6 months, and the utility of the PMMC flap was evaluated for HFN reconstruction.
Results:
Of the 496 patients, complications developed in 84 patients. The complications included complete flap failure in 12, partial skin paddle loss in 24, wound infection in 12, peripheral wound dehiscence in 16, plate exposure in 12, and donor site morbidity such as infection and a decrease in function in 8.
Conclusions:
The PMMC flap or its modification was used in 496 cases of reconstruction after resection surgery for malignancy of the HFN region with minimal morbidity and 1 death. This technique is a useful alternative in places with a high incidence of HFN malignancies and microsurgical free tissue transfer is not possible or as a salvage procedure in selected large, full-thickness, oral cavity lesions. In our 19-year experience, the final functional and cosmetic results were satisfactory with this sturdy flap.
