Table of Contents Author Guidelines Submit a Manuscript
The Scientific World Journal
Volume 2012, Article ID 384179, 7 pages
http://dx.doi.org/10.1100/2012/384179
Clinical Study

Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

1Department of Head and Neck Surgery, ABC Medical School, São Paulo, SP, Brazil
2Department of General Surgery, ABC Medical School, São Paulo, SP, Brazil
3Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil
4São Paulo State Cancer Institute and Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil

Received 29 December 2011; Accepted 12 February 2012

Academic Editors: G. Dolivet, M. Hambek, and P. O-Charoenrat

Copyright © 2012 Christiana Maria Ribeiro Salles Vanni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications. Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction. Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria. Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx ( 𝑃 = 0 . 0 1 3 ) as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment ( 𝑃 = 0 . 0 0 2 ). The former condition is also associated with major reconstruction failure ( 𝑃 = 0 . 0 1 8 ). An even lower incidence of major complications was noted in patients under the age of 53 ( 𝑃 = 0 . 0 4 4 ). Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.