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Subpectoral gliding tissue flap

W Millesi1, G Schobel, T Bochdansky

  • 1Clinic of Oral and Maxillofacial Surgery, University of Vienna, Austria.

Plastic and Reconstructive Surgery
|April 1, 1994
PubMed
Summary
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This study confirms a gliding tissue flap between pectoral muscles can prevent recurrent fibrosis after brachial plexus neurolysis. This technique successfully treated eight patients with recurrent pain syndromes.

Area of Science:

  • Anatomy
  • Surgical Innovation
  • Regenerative Medicine

Background:

  • Recurrent fibrosis and pain syndromes following brachial plexus neurolysis pose significant clinical challenges.
  • The anatomical basis for utilizing intermuscular connective tissue as a potential flap for nerve coverage was investigated.

Observation:

  • Cadaver dissection revealed a distinct connective tissue layer between the pectoralis major and pectoralis minor muscles.
  • This tissue layer is vascularized by the pectoral branch of the thoracoacromial artery, enabling the creation of a pedicled flap.

Findings:

  • A subpectoral gliding tissue flap was successfully created and transposed in nine patients undergoing neurolysis for brachial plexus issues.
  • Eight out of nine patients experienced relief from recurrent pain syndromes, attributed to the flap enveloping the neurolyzed nerves and preventing fibrosis.

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  • Post-transposition, the pectoralis major muscle exhibited minimal clavicular segment atrophy with no functional impairment, confirmed by physical examination and electromyography.

    • Implications:

    • This study demonstrates the clinical utility of a novel subpectoral gliding tissue flap for preventing post-neurolysis adhesions.
    • The technique offers a promising solution for managing recurrent pain syndromes associated with brachial plexus injuries.
    • Further research into optimizing flap design and patient selection may enhance outcomes in complex nerve reconstruction procedures.