The Use of Pectoralis Major Myocutaneous Flap as Salvage Procedure in Complications after Head and Neck Surgery

Korean Journal of Head & Neck Oncology 2011;27(1):12-16.
Published online May 30, 2011.

Young-Hoon Joo;Kwang-Jae Cho;Jun-Ook Park;In-Chul Nam;Dong-Il Sun;Min-Sik Kim

두경부암 수술 후 발생한 합병증에서 대흉근피판의 임상적 유용성

주영훈;조광재;박준욱;남인철;선동일;김민식

Abstract

Background and Objectives：The pectoralis major myocutaneous flap(PMMCF) has been considered to be the “workhorse” of pedicled flaps in head and neck reconstruction. Even with the worldwide use of free flaps, the PMMCF is still considered the mainstay in head and neck reconstruction. The aim of the study is to evaluate the application and reliability of the PMMCF in selected cases of head and neck complication. Materials and Methods：We conducted a retrospective review of 14 patients who underwent the surgical reconstruction us-ing the PMMCF due to the complications after head and neck ablative surgery between 1997 and 2007. Out-come measures included the indications of PMMCF, complications and post-operative functional result. Re-sults：PMMCFs were used to reconstruct defects in the following series; wound dehiscence(7 patients), flap failure(4 patients), pharyngocutaneous fistula(3 patients). Flap survival was 100 percent and mean flap size was 67.2cm 2 . Five patients had complications such as pharyngocutaneous fistula, marginal necrosis, carotid blowout. Conclusions：The PMMCF is a safe and convenient method for reconstruction of the surgical com-plications after resection of advanced tumors and can be still used as a salvage procedure after free flaps failure.

Key Words: Pectoralis muscles, Surgical flaps, Postoperative complications