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. 2024 Feb;76(1):336-343.
doi: 10.1007/s12070-023-04159-5. Epub 2023 Sep 16.

Bipaddle Pectoralis Major Myocutaneous Flap (PMMC) for Complex Composite Oral Cavity Defects: An Experience of a Tertiary Cancer Centre

Bhoopendra Singh Gora  1 , Shubhra Sharma  1 , Pinakin Patel  1 , Kamal Kishor Lakhera  1 , Suresh Singh  1 , Agil Babu  1 , Pranav Mohan Singhal  1 , Naina Kumar Agarwal  1
Affiliations

Bipaddle Pectoralis Major Myocutaneous Flap (PMMC) for Complex Composite Oral Cavity Defects: An Experience of a Tertiary Cancer Centre

Bhoopendra Singh Gora et al. Indian J Otolaryngol Head Neck Surg. 2024 Feb.

Abstract

Although microvascular free flaps are considered the first choice in head and neck cancer defect reconstruction, their use is limited in developing regions by availability of resources and the expertise .The Bipaddle pectoralis major myocutaneous flap (PMMC flap) is a commonly used flap in head and neck cancer reconstruction, but in literature flap is associated with high incidence of drawbacks including donor site morbidity and added bulk of the flap reducing cosmetics and function. The purpose of the study is to evaluate the Bipaddle PMMC flap reliability, operative technique and outcome in reconstructive head and neck cancer surgery in the era of microvascular free flaps. Its a prospective study in which the records of 50 patients treated with Bippadle PMMC flap reconstruction between January 2022 to July 2022 were systematically collected and reviewed. Data of recipient site, serum albumin, history of adjuvant, recurrence, defect dimension, type of donor site closure, length of hospital stay, postoperative complications and outcomes were analysed. There were 45 males and 5 females with a mean age of 41 years (31-60). Bipaddle PMMC flap reconstruction was done in all patients of advanced squamous cell carcinoma of oral cavity. There were two males with complete necrosis of flap salvaged with latissimus dorsi flap and forehead flap. Minor infections were noted in two female and one male patient, managed conservatively and recovered well with acceptable final outcome. The Bipaddle PMMC flap is reliable for large defects in head and neck reconstructive surgery, particularly when a bulky flap is required to reconstruct composite defects where the lesion is involving the skin. Placing the flap horizontally with inclusion of nipple and areola in most of the patients increased the reach and size of available flap.

Keywords: Bipaddle pectoralis major myocutaneous flap (PMMC flap); Full thickness cheek and oral defects; Operative technique.

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Conflict of interest statement

Competing InterestsNo competing interests to declare.Conflict of InterestAuthors would like to declare there is no funding from institution or commercial company with regard to this study.

Figures

Fig. 1
Fig. 1
Picture showing advance carcinoma buccal mucosa
Fig. 2
Fig. 2
Picture showing defect after surgical resection
Fig. 3
Fig. 3
Picture showing closure of defect with large PMMC flap
Fig. 4
Fig. 4
Picture showing flap necrosis
See this image and copyright information in PMC

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