The pectoralis major myocutaneous pedicled flap is a commonly used flap for reconstructive head and neck surgery, but associated with high complication rates. The purpose of this study was to evaluate a refined surgical technique that can reduce flap complications and compare the proposed technique with the conventional surgical technique. A retrospective analysis was performed on 35 consecutive patients affected by malignant tumors of the head and neck, who underwent a pectoralis major myocutaneous pedicled flap reconstruction in our institution, between 2004 and 2009. Patients were divided into 2 groups: group 1 treated by the classic surgical technique, and group 2 treated by the refined surgical technique. Our main outcome measures were the success of the reconstructions and the complications. The overall complication rate in patients who underwent our revisited surgical technique was significantly lower than that in patients who underwent conventional surgical technique (P = 0.001). The results of our study reinforce the value of the pectoralis major flap in the reconstruction of head and neck defects and shows how little refinement of the surgical technique can significantly reduce the onset of complications. © 2013 by Mutaz B. Habal, MD.
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