Pectoralis Major Myocutaneous Flap Reconstruction in Head-and-Neck Malignancy – Experience from a Tertiary Care Center

ABSTRACT

Background: The pectoralis major myocutaneous (PMMC) flap as a pedicle flap is still a reliable option to reconstruct thedefects following major oncological resections of head-and-neck cancer. It is the workhorse in centers where the facilities forfree tissue transfer are not available. Our aim is to assess the complications of PMMC flap reconstruction.Materials and Methods: A retrospective analysis of records of 17 patients who underwent reconstruction with PMMC flapas a pedicle flap for head-and-neck malignancies from 2013 to 2019 in the Department of Surgical Oncology, GovernmentThoothukudi Medical College Hospital, Thoothukudi, was performed.Results: Records of 17 patients who received PMMC flap were taken for analysis. Of those 17 patients, three were female. Ofthose 17 patients, 15 had oral cavity malignancy and 2 had malignant parotid tumors. PMMC was used to cover the mucosaldefect in eight patients, skin defect in two patients, and both in seven patients as bipaddle flap. None of the patients had a totalloss of flap, but one case of marginal necrosis and three cases of partial intraoral flap dehiscence were noted. Oral cavity defectaccounts for 15 flaps and the remaining 2 were done to reconstruct the defect following resection of the malignant parotid tumor.Conclusion: In centers without free tissue transfer facility, PMMC is still the gold standard flap in head-and-neck reconstruction.The morbidity is very minimal in experienced hands.