Related Experiment Video
Updated: Jul 18, 2025
In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
Published on: June 8, 2013
Has the Pectoralis Major flap Really Become Obsolete?
Arpan Choudhury1, Murtuza I Laxmidhar1, Neelam Ahirwar1
1Department of Surgical Oncology, Apollo Hospitals Ahmedabad, Plot No.1 A, Bhat GIDC Estate, 382428 Gandhinagar, India.
Aim:
To evaluate the current role of pectoralis major (PM) flap including the reasons for selecting it over free flaps.
Materials And Methods:
All patients who underwent PM flap at Apollo Hospitals Ahmedabad during the 3-year period from January 2020 to December 2022 were included. Patient demographics, tumour characteristics and complications were studied and reasons for selecting pectoralis major flap were analyzed. Data was entered in Microsoft excel spreadsheet and analyzed using online statistical calculators. The p value of < 0.05 was considered statistically significant.
Results:
57 patients underwent reconstruction with PM flap while 154 patients underwent free flap reconstruction. 54 were male and 3 were female. Median age was 51 years. PM flap was used for intraoral lining in 25 patients, and it was bilobed in 26 patients with full thickness cheek defect. Most common complication was wound infection seen in 10 patients. 5 patients developed marginal necrosis of the flap and 5 had donor site wound dehiscence. No complete flap loss was seen. During the same period, 15/154 (9.74%) patients with free flaps developed complete flap necrosis and this was statistically significant (p = 0.012). Reasons for choosing PM flap were also analyzed. 14 patients had major comorbidities, 18 had extensive disease, in 5 patients it was used for salvage post free flap failure, while 10 previously treated patients had unavailability of suitable vessels for anastomosis. 12 patients underwent PM flap due to financial constraints.
Conclusion:
Thus, PM flap is not obsolete and continues to maintain its place in head and neck reconstruction.
Insights
The pectoralis major (PM) flap remains a valuable option for head and neck reconstruction, offering a lower rate of complete flap loss compared to free flaps. This study highlights its continued relevance in reconstructive surgery.
Area of Science:
- Plastic Surgery
- Head and Neck Reconstruction
- Reconstructive Surgery
Background:
- The pectoralis major (PM) flap is a reconstructive option in head and neck surgery.
- Its current role and comparison with free flaps require evaluation.
Purpose of the Study:
- To assess the current utility of the pectoralis major (PM) flap.
- To identify reasons for selecting the PM flap over free flaps in head and neck reconstruction.
Main Methods:
- A retrospective study of patients undergoing PM flap reconstruction at Apollo Hospitals Ahmedabad from January 2020 to December 2022.
- Analysis of patient demographics, tumor characteristics, complications, and reasons for flap selection.
- Comparison of outcomes with free flap reconstructions.
Main Results:
- 57 patients underwent PM flap reconstruction; 154 underwent free flap reconstruction.
- The PM flap had a significantly lower rate of complete flap necrosis (0% vs. 9.74% for free flaps, p=0.012).
- Common reasons for PM flap use included comorbidities, extensive disease, salvage, vessel unavailability, and financial constraints.
Conclusions:
- The pectoralis major (PM) flap is not obsolete and remains a viable and important option for head and neck reconstruction.
- Its selection is often influenced by patient comorbidities, disease extent, and resource availability.
Related Concept Videos
01:23Muscles of the Shoulder
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, and...
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:31Muscles that Move the Arm
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...