[Myocutaneous flaps of the pectoralis major. Anatomy, technic and clinical applications]

The authors emphasize the versatility of the pectoralis major myo-cutaneous flap in head and neck reconstruction. They describe the vascular anatomy of the flap after dissection and catheterization of the deep pectoral branch of the acromio-thoracic artery in twenty cadavers. They emphasize the consistency and the size of this artery and describe a rich and regular network of perforating myo-cutaneous arteries. These allow a high versatility in the size of the cutaneous area. The use of this flap to cover carcinologic or post-radiotherapic defect is indicated because it brings a richly vascularized muscular tissue. The arc rotation of the flap is very large and permits reconstructions in axillary, thoracic and facial area. A "S" superior incision save the possibility of using a homolateral delto-pectoralis cutaneous flap. The authors present five typical clinical applications of this flap.