Title: Pectoralis Major Myo-cutaneous Flap Work-Horse In Reconstruction of Oral Cavity Cancers
Authors: T.Mohan Vijay Kumar, Guduru Sumanth, Kaushik Hari Mch (Surgical Oncology)
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.03
Abstract
Today, in the era of microvascular reconstructive surgery is well-grounded in the vernacular of microvascular surgeon as well as the increasingly more educated public. One of the concepts in head and neck reconstruction surgery is that whenever possible, one should try to reconstruct the defects with tissues that more closely resemble the missing part not only in color but also in thickness and the texture.
Equally important in the reconstructive is to keep in mind the needs of our subjects and their consent to undergo a more extensive reconstruction surgery using free tissue transfer. In those cases, as well as those where the free grafts transfer has failed, the use of pedicled local or regional flaps is an essential aspect of the armamentarium of reconstructive surgeons.
Though free flaps are presently the gold standard for head and neck reconstruction, PMMC flaps remain a robust, versatile pedicled workhorse flap used for a variety of head and neck reconstructions with a comparatively easier learning curve and a shorter operating time to ease the enormous workload in our hospitals.
In this article, we have reviewed 30 head and neck cancer cases, which we had done in the Surgical oncology department of Nri Medical College, Chinna Kakani in which we have used the PMMC flap as a reconstructive tool for various defects produced after resection of head and neck malignancies. These include buccal mucosal cancers, cancer of the floor of mouth, tongue, retromolar trigone, lip, mandible, and parotid gland.
We did not have even one case of total flap necrosis. However, minor complications like partial flap necrosis, infection, wound dehiscence, and the oro-cutaneous fistula was present in a few of our cases.
We thus conclude that PMMC flap remains as one of the main flaps for salvage reconstruction secondary to the loss of the microvascular flaps as well as in those patients in whom microvascular flaps are either contraindicated or cautioned due to existing comorbidities that diminish their ability to tolerate an extended operating time.
