The pectoralis major myocutaneous flap in reconstructive head and neck surgery revisited: a recent experience

Although the pectoralis major myocutaneous flap (PMMF) has proved to be a reliable method of reconstruction for the head and neck surgeon, the current emphasis in tissue replacement has shifted to microvascular free-tissue transfer. This has prompted us to review retrospectively all PMMFs performed for reconstruction following head and neck cancer resection at the University of Connecticut Health Center over a recent four-year period. A total of 24 flaps were utilized consecutively in 23 patients, following a variety of ablative procedures. Postoperative complications occurred in 14 of the 24 flaps (59%), and 11 of the 14 patients who experienced postoperative complications had received previous radiation therapy. Seven of the complications were felt to be major because they prolonged hospital stay, or they required secondary reconstructive procedures (four of seven cases). There were no instances of total flap failure. In our experience, the PMMF has proved to be reliable and useful in a variety of head and neck reconstructive procedures. We conclude that the PMMF remains an excellent option for repair of defects resulting from head and neck cancer resection.