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Indications and Outcomes for Pedicled Pectoralis Major Myocutaneous Flaps at a Primary Microvascular Head and Neck Reconstructive Center

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Modern Plastic Surgery 2012年第4期2卷 103-107页

作者： Akira Saito Hidehiko Minakawa Noriko Saito Tatsumi Nagahashi Department of Plastic and Reconstructive Surgery Graduate School of Medicine Hokkaido University Sapporo Japan Division of Head and Neck Surgery Hokkaido Cancer Center Sapporo Japan Division of Plastic and Reconstructive Surgery Hokkaido Cancer Center Sapporo Japan

The pectoralis major musculocutaneous (PMMC) flap has been a useful technique for head and neck reconstruction since its first description by Ariyan in 1979. However, techniques in microvascular surgery have since evolved and recently free tissue transfer has played an important role in head and neck reconstruction. Although we use free flaps as the first choice for head and neck reconstruction, similar to many other institutions, some patients at our hospital have undergone reconstruction with PMMC flaps. We retrospectively analyzed the indications and outcomes of this reconstructive technique from our experience with 12 patients. The medical records of all patients who underwent PMMC flaps at Hokkaido Cancer Center from 2001 to 2010 were reviewed. Data concerning diagnosis, main indication, site of reconstruction, previous treatment, and postoperative complications were analyzed. Of the 12 PMMC flap surgeries performed, 3 were carried out as primary reconstructive procedures, whereas 9 were done as “salvage” procedures. Flap-related complications were observed in 6 cases. Partial flap loss developed in 4 patients, although there were no cases of total flap loss. There were 3 recurrent fistulae following reconstruction with PMMC flaps. The preoperative goals of performing PMMC flap surgery were met in 83% of our cases. The authors conclude that while free flap transfer is usually the first choice for head and neck reconstruction, PMMC flaps can produce acceptable results in certain situations.

关键词： Pectoralis Major Myocutaneous Flap Head and Neck Reconstruction Pedicled Flap Pedicled Pectoralis Major Myocutaneous Flap Reconstruction Microsurgery

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