Online ISSN: 2515-8260

Keywords : postoperative complications

―Comparison of Pectoralis Major Myocutaneous Flap with and without Lateral Axillary Incision in Reconstruction of Soft Tissue Defect in Head and Neck Region‖- A Pilot Study

Dr. Manan Gupta; Dr. Nitin Bhola

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2105-2115

Abstract: Background - Major ablative surgeries leads to soft and hard tissue defects which
require reconstruction which gives better functional and aesthetic outcomes. Pectoralis
major myocutaneous (PMMC) flap is a workhorse flap for soft tissue reconstruction owing
to its merits. The conventional technique of harvesting PMMC flap is associated with
donor site complications such as functional deformity and scar contracture. A modified
technique without lateral axillary incision for harvesting PMMC flap may provide better
results. Aim - To compare the two incision designs of harvesting PMMC flap (with lateral
axillary incision and without lateral axillary incision) in soft tissue defect reconstruction in
head and neck region. Methodology – A prospective pilot study will be performed on 16
patients diagnosed with OSCC requiring resection, neck dissection and reconstruction with
PMMC flap. These patients will be allocated to two groups by alternate randomization,
Group A PMMC flap harvest with lateral axillary incision and Group B PMMC flap
harvest without lateral axillary incision. The patients will be subjected to General
anaesthesia and surgery will be performed by single experienced surgeon. Parameters
assessed will be time taken for harvesting the flap, time required for closure of donor site,
flap survival, range of motion (ROM) of shoulder (Degree of endorotation and
exorotation), complications (hematoma, seroma, dehiscence, marginal necrosis, infection)
and scar formation. The obtained data will be filled in MS excel sheet and statistical
analysis will be done. Expected result – The modified technique would prove better in
terms of function and aesthetic with minimal complications and that it will provide new
insight in choosing the best approach with minimal complications for harvesting of PMMC
flap. Conclusion - The results if favours the modified technique with respect to time of
harvesting, time of closure of donor site and complications, will help in the reconstruction
of such defects with minimal donor site complications and improved outcomes.

Post Operative Outcomes In Relation To Illiac Graft Donor Site With Drain And Without Drain: A Comparitive Study

Dr. Sri Sujan Suryadevara; Dr. Eklavya Sharma; Dr. Mohammed Ibrahim; Dr. Rahul VC Tiwari; Dr. Sriram Choudary Nuthalapati; Dr. Md. Jawed Iqbal; Dr. Heena Tiwari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 6514-6520

Aim: To evaluate post-operative outcomes of anterior iliac bone graft after alveolar bone grafting in cleft patients with and without surgical drain.
Methodology: Forty patients with cleft alveolus were randomly selected and divided into two groups. Group 1 consisted of 20 patients (assessment finished drain attached to iliac graft) and Group 2 consisted of 20 patients (assessment steer clear off drain in respect to iliac graft). Evaluation was finished the assistance of questionnaire in terms of pain (with the assistance of visual analogue scale starting from 1 10), gait (through observation), infection and wound healing (through clinical examination) in both the groups. Chi square test was employed to gauge the comparison between various variables.
Results: In our study we observed that post operatively on day 1, patients in both group I and II, mostly were tormented by unbearable pain which was however controlled with high dose IV analgesics. By day 3, pain intensity dropped in patients without drain which was statistically significant (p=0.032). In Group I patients, around 54 available around 20 29 ml of fluid collection through the drain on day 1, which led to extreme discomfort for the patients and was statistically significant further (p=0.032).Conclusion: Closed suction drainage has no effect on wound healing following the removal of bone from the iliac crest to be used as a graft.