Indications and Outcomes for Pedicled Pectoralis Major Myocutaneous Flaps at a
Primary Microvascular Head and Neck Reconstructive Center
106
In our series, 5 out of the 6 patients (83%) who devel-
oped complications had a history of preoperative radio-
therapy, while only 1 of 6 patients (17%) who did not
develop complications had undergone preoperative ra-
diotherapy. However, this difference was not statistically
significant.
Three out of 5 patients with fistula had recurrences af-
ter the reconstructive procedures, with 2 of them devel-
oping fistula recurrence following partial flap loss. Since
many cases with fistula have a prior history of radiation,
which delays healing, when the primary indication of the
procedure is to repair a fistula, special care should be
taken to safely elevate the flap in order to minimize ne-
crosis.
In conclusion, of 12 PMMC flap surgeries performed
at our institution, 3 were carried out as primary recon-
structive procedures, whereas 9 were done as “salvage”
procedures. Major complications were observed in 3 pa-
tients (25%), and minor complications were seen in 3
patients (25%). Partial flap loss developed in 4 patients
(33%), although there were no cases of total flap loss.
The preoperative goals of the flaps were met in 83% of
our cases.
5. Conclusion
The authors conclude that although free flap transfer is
most often the first choice for head and neck reconstruct-
tion, PMMC flaps can produce acceptable results in cer-
tain situations.
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