Deltopectoral Flap in Head and Neck Reconstruction

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• The deltopectoral (DP) flap, a fasciocutaneous flap from the anterior chest wall, remains a reconstructive option for head and neck defects.
• While free flaps have become more prevalent, the DP flap retains its utility for patients unsuitable for free flap reconstruction.
• This study evaluates the efficacy and complications of the DP flap in head and neck reconstruction.

Purpose of the Study:

• To assess the surgical outcomes and complication rates of the deltopectoral (DP) flap in head and neck reconstruction.
• To identify patient factors associated with complications following DP flap use.

Main Methods:

• A retrospective analysis of 31 patients undergoing head and neck reconstruction using a DP flap.
• Data collected included patient demographics, recipient site, donor site closure, and flap complications.
• The delayed technique for flap harvesting was not utilized; flaps were extended beyond the deltopectoral groove as needed.

Main Results:

• The median time for DP flap autonomization was 23 days.
• Overall postoperative complications occurred in 32.3% of patients, with partial flap necrosis in 16.1% and complete necrosis in 3.2%.
• Diabetes mellitus was significantly associated with increased flap necrosis (66.7% in diabetic patients vs. 8.0% in non-diabetic patients).

Conclusions:

• The DP flap is a versatile option for head and neck reconstruction with a generally low complication rate.
• The delayed technique is not essential, and flap extension is feasible.
• Diabetic patients represent a high-risk group for distal flap necrosis, requiring careful consideration.