Unravelling the Hidden Complication: Costal Osteomyelitis of the PMMC Donor Site

The Pectoralis Major Myocutaneous Flap (PMMC) has been an essential part of the armamentarium of surgeons reconstructing oral cavity defects after resection for malignancies. Ease of harvest, reliability and versatility coupled with minimal donor site and flap related morbidities have made the PMMC a favorite of reconstructive surgeons and surgical oncologist, especially in situations where a free flap reconstruction is either not possible or expertise and logistics don't support such a procedure. But like any other surgical procedure, the PMMC also suffers from various complications. This case report describes a rather unusual complication of Costal Osteomyelitis of the 5-8th rib of the donor site following harvest of the PMMC for reconstructing the ipsilateral buccal mucosa defect after resection for oral cavity.