Back to the Roots-Reconstructing Full Thickness Oral Cavity Defects in Women With the Versatile Bi-Folded PMMC Flap

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery

Background:

• Reconstruction of full-thickness oral cavity defects presents surgical challenges.
• Free flaps are preferred but often inaccessible due to cost and resource limitations.
• The Pectoralis major myo-cutaneous (PMMC) flap serves as a viable alternative in such scenarios.

Purpose of the Study:

• To analyze the complications and functional outcomes of oral cavity reconstruction using bi-folded PMMC flaps in female patients.
• To evaluate the PMMC flap's efficacy in resource-limited settings.

Main Methods:

• A retrospective analysis of 60 female patients who underwent reconstruction with bi-folded PMMC flaps between July 2020 and June 2022.
• Data collected included patient factors, flap-related complications, and functional outcomes.

Main Results:

• The overall complication rate was 46.6%, with flap detachment (23.3%) being the most common.
• Other complications included orocutaneous fistula (16.6%), surgical site infection (11.66%), and oral commissural incontinence (11.66%).
• Flap failure occurred in 5% (complete) and 11.66% (partial); 33.33% required a second surgery. Functional outcomes for swallowing and speech were generally acceptable.

Conclusions:

• The PMMC flap is a robust, dependable, and economical choice for oral cavity defect reconstruction.
• It provides acceptable functional outcomes, especially where microvascular surgery is unavailable or unaffordable.