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Journal of Maxillofacial and Oral Surgery

05-03-2024 | Wound Dehiscence | ORIGINAL RESEARCH

Evaluating the Success of Pectoralis Major Myocutaneous Flap in Mandibular Reconstructions in Relation to Defect Localization

Authors: Goksel Timarcioglu, Ozge Sen, Ecem Gedik, Utku Bahran, Mert Karacakurtoglu, Celal Candirli

Published in: Journal of Maxillofacial and Oral Surgery

Abstract

Objectives

In this study, the success of mandibular reconstructions with pectoralis major myocutaneous flaps (PMMF) was assessed based on the location of the defect.

Materials and Methods

The data obtained from patients who had previously undergone PMMF reconstruction during a 3-year period, from 2018 to 2021, was retrospectively analyzed using predetermined criteria (postoperative complications, flap survival). Cases included were treated using Urkens’ technique at the Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital of the University of Health Sciences, defects were classified according to Browns’ classification.

Results

18 individuals, ages ranging from 28 to 82 (M: 59.05) with differing diagnoses (squamous cell carcinoma [SCC] [n = 11], myoepithelial carcinoma [MEC] [n = 1], osteosarcoma [n = 3], medication-related osteonecrosis [MRONJ] [n = 2], gunshot wound [n = 2]) were chosen for the analysis. Based on Browns’ classification, 8 defects were noted to be Class I, while the remaining 4 and 6 were classified as class II and class III, respectively. Postoperative complications in class III cases included partial necrosis (n = 4), orocutaneous fistula (n = 3), wound dehiscence (n = 2) and plate exposure (n = 3). No major postoperative complications occurred in class I and majority of the class II defects. Class I cases had a 100% success rate (n = 8), while the reconstruction of class III defects had a significantly lower success rate, with only 1 of the 6 cases considered successful. Compared to Class III, the class II cases had a relatively high success rate (75%, n = 3), one of the cases being considered unsuccessful.

Conclusion

In comparison with class I and II, Class III defects involving the anterior mandible were found to have a higher rate of complications. This difference in clinical outcome is thought to be associated with decreased flap vascularity stemming from the arc of rotation. Utilizing free flaps will provide a better clinical outcome in aforementioned defects; thus, in Class III defects, PMMF should be preferred when free flaps are contraindicated or as a salvage flap.

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Title: Evaluating the Success of Pectoralis Major Myocutaneous Flap in Mandibular Reconstructions in Relation to Defect Localization
Authors: Goksel Timarcioglu
Ozge Sen
Ecem Gedik
Utku Bahran
Mert Karacakurtoglu
Celal Candirli
Publication date: 05-03-2024
Publisher: Springer India
Keyword: Wound Dehiscence
Published in: Journal of Maxillofacial and Oral Surgery
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI: https://doi.org/10.1007/s12663-024-02126-3

At a glance: The STEP trials

Springer Medicine

Evaluating the Success of Pectoralis Major Myocutaneous Flap in Mandibular Reconstructions in Relation to Defect Localization

Abstract

Objectives

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and Methods

Results

Conclusion

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