[The experience of abundant amount of pectoralis major myocutaneous flap tissue in restoring parenchyma defect of head and neck]

Objective:Explore the skills to flap the defects of the head and neck with myocutaneous of pectoralis major which has rich amount of organization to minimize complications.Method:Various of neck defects will be repaired when the myocutaneous flap of pectoralis major from obese male or/and female has been prepared with improved methods. First of all, the muscle must be fixed. Then we have to suture the skin and the defect of skin or mucous membrane;the potential closed cavities around the myocutaneous flap must be drainaged with the negative pressure after repaired. Clinical data of 23 (24 sides) patients undergoing the repair in our hospital between January 2008 and December 2014 were collected and reviewed retrospectively.Result:One of 23 cases was injured the thoracoacromial artery in the preparation process of myocutaneous flap by the operator, then we operated on the other side. All of the pectoralis major myocutaneous flaps has been survived except 1 case which was necrosis in distal partial of pectoralis major muscle flap, but healed after changing dressing.Three cases with pharyngeal leakage because of the infection were also healed after changing dressing; skin and skin flap partial dehiscence happend in 1 cases, but also healed after dressing; 1 cases with subcutaneous hemorrhage was healed after cleaning up hematocele.Conclusion:The pectoralis major myocutaneous flap is still a good material for the repair of head and neck defects as long as the management skill in perioperative has been mastered properly, even though the one with rich amount of organization is bloated and the preparation and repair is difficult.