The rib-pectoralis major osteomyocutaneous flap

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Regenerative Medicine

Background:

• Mandibular defects require complex reconstruction.
• Osteomyocutaneous flaps are a common reconstructive option.

Observation:

• A composite flap using pectoralis major muscle, rib, and skin was utilized.
• The flap was tunneled superiorly, with muscle protecting great vessels.
• Skin lined oral cavities or filled external defects; rib replaced mandible.

Findings:

• The rib demonstrated adequate vascularization, survival, and no resorption.
• Boney union was painless and clinically firm in 14 patients.
• One flap was lost, ribs removed in 3, and one fistula occurred.

Implications:

• This composite flap is a reliable option for mandibular reconstruction.
• The technique offers durable bone replacement and soft tissue coverage.
• Further evaluation may refine outcomes and minimize complications.