True island pectoralis major myocutaneous flap: its advantages / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Pectoralis major myocutaneous flap(PMMCF) is a workhorse flap of head and neck reconstruction and it has four types depending on its nature of vascular pedicle. True island type PMMCF has many advantages over conventional muscular type, but reports on this type of flap and its advantages are lacking. Material and METHOD: Fifty two PMMCF(50 patients) used for head and neck reconstruction between 1992 and 1998 were reviewed retrospectively. There were 16 muscular type and 36 true island type PMMCF. We compared the incidence of complication between two groups. RESULT: Six marginal necrosis(less than 20%) and 1 major necrosis(more than 50%) developed in 16 muscular type PMMCF. However in 36 true island type PMMCF, 1 marginal necrosis and 2 major necrosis developed. CONCLUSION: True island type PMMCF has the following advantages over muscular type. 1. True island type has 3-4 cm gain in length. 2. Flap could be harvested at more cephalic portion of the chest. 3. Unwanted tension of the flap could be avoided. 4. Vascular pedicle is not compressed between skin and clavicle. 5. The rotation of vascular pedicle is natural without kinking. 6. Ugly bulge over clavicle is absent postoperatively. 7. This type could be used regardless of types of neck dissection.