Archives of Plastic Surgery

  • 제39권5호
  • /
  • Pages.522-527
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  • 2012
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Analysis of 120 Pectoralis Major Flaps for Head and Neck Reconstruction

  • You, Young Sun (Department of Plastic and Reconstructive Surgery, Hallym University Medical Center) ;
  • Chung, Chul Hoon (Department of Plastic and Reconstructive Surgery, Hallym University Medical Center) ;
  • Chang, Yong Joon (Department of Plastic and Reconstructive Surgery, Hallym University Medical Center) ;
  • Kim, Kuyl Hee (Department of Plastic and Reconstructive Surgery, Hallym University Medical Center) ;
  • Jung, Sung Won (Department of Plastic and Reconstructive Surgery, Hallym University Medical Center) ;
  • Rho, Young Soo (Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Center)
  • 투고 : 2012.05.30
  • 심사 : 2012.08.01
  • 발행 : 2012.09.15
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초록

Background A pectoralis major flap is one of the standard tools for the reconstruction of defects of the head and neck. Despite the technical advancement in free tissue transfer in head and neck reconstruction, the benefits of a pectoralis major flap should not be overlooked. The purpose of this study is to evaluate our 17 years of experience in reconstructing defects of the head and neck region using the pectoralis major flap. Methods We retrospectively reviewed the medical records of 112 patients (120 cases) who underwent pectoralis major flap operations for head and neck reconstruction during a period ranging from 1994 to 2010. Results In our series, no total necrosis of the flap occurred. Of the total cases, 30.8% presented with flap-related complications. Major complications occurred in 20% of all of the cases but were then all successfully treated. The male sex was correlated with the occurrence of overall complications (P=0.020) and major complications (P=0.007). Preoperative albumin levels of <3.8 g/dL were correlated with the formation of fistula (P=0.030). Defects of the hypopharynx were correlated with the occurrence of major complications (P=0.019) and the formation of fistula (P=0.012). Secondary reconstructions were correlated with the occurrence of overall complications (P=0.013) and the formation of fistula (P=0.030). Conclusions A pectoralis major flap is still considered to be a safe, versatile one-stage reconstruction procedure in the management of the defects of head and neck and the protection of the carotid artery.

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참고문헌

  1. Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 1979;63:73-81. https://doi.org/10.1097/00006534-197901000-00012
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  7. Shah JP, Haribhakti V, Loree TR, et al. Complications of the pectoralis major myocutaneous flap in head and neck reconstruction. Am J Surg 1990;160:352-5. https://doi.org/10.1016/S0002-9610(05)80541-0
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  10. IJsselstein CB, Hovius SE, ten Have BL, et al. Is the pectoralis myocutaneous flap in intraoral and oropharyngeal reconstruction outdated? Am J Surg 1996;172:259-62. https://doi.org/10.1016/S0002-9610(96)00161-4
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  13. Corten EM, Schellekens PP, Hage JJ, et al. Clinical outcome after pedicled segmental pectoralis major island flaps for head and neck reconstruction. Ann Plast Surg 2009;63:292-6. https://doi.org/10.1097/SAP.0b013e31818938bb
  14. Pinto FR, Malena CR, Vanni CM, et al. Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome. Sao Paulo Med J 2010;128:336-41. https://doi.org/10.1590/S1516-31802010000600005
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  2. The lateral thoracic artery revisited vol.36, pp.6, 2012, https://doi.org/10.1007/s00276-013-1234-x
  3. Regional flaps: a move to simpler reconstructive options in the head and neck vol.22, pp.5, 2012, https://doi.org/10.1097/moo.0000000000000090
  4. Comparison of Clinical and Functional Outcomes Using Pectoralis Major and Cutaneous Free Flaps for Hypopharyngeal Squamous Cell Carcinoma vol.42, pp.5, 2012, https://doi.org/10.5999/aps.2015.42.5.608
  5. Temporal trends in head and neck cancer surgery reconstruction vol.37, pp.10, 2012, https://doi.org/10.1002/hed.23786
  6. Analysis of 130 Cases of Pectoralis Major Flap for the Head and Neck Reconstruction vol.59, pp.2, 2012, https://doi.org/10.3342/kjorl-hns.2016.59.2.133
  7. Outcomes after free tissue transfer for composite oral cavity resections involving skin vol.40, pp.5, 2012, https://doi.org/10.1002/hed.25062