Online ISSN: 2515-8260

Keywords : Pectoralis Major Myocutaneous flap

―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.