Versatility of pectoralis major myocutaneous flap in oncosurgery and its role in developing countries

The objective of this study was to assess the versatility of pectoralis major myocutaneous (PMMC) flap in the reconstruction of diverse surgical defects following resection of various head and neck malignancies. We performed retrospective analysis of patients in whom PMMC was used to reconstruct head and neck surgical defects during May 2006 to December 2010. The study was carried out at KLES Dr. Prabhakar kore Hospital & M.R.C, Belgaum and involved 95 patients. The patients were grouped depending on the site of defect reconstructed and were analyzed in detail. Of the 95 patients, between the age group 38 and 62 years, 69 patients were males while 26 patients were females. PMMC was used to reconstruct 59 cases of oral mucosal defect, ten cases of skin defect and 18 cases of simultaneous oral mucosal and outer skin defect. PMMC was also used in two cases of laryngopharyngeal defects and six cases with floor of mouth and tongue defects. No failures were noted in the study during the follow up period. Despite worldwide emphasis on free flaps as gold standard in the reconstruction of tissue defects, institutions in developing countries where financial constraints are encountered or as salvage procedure for free flap failure, PMMC due to its versatility is still considered the workhorse for reconstruction of moderate to large sized head and neck defects.