Evaluation of flap complications following pectoralis major myocutaneous flap reconstruction for oral cancers

Background

Oral cavity cancer is among the leading cause of cancer death in India. Pectoralis major myocutaneous flaps (PMMC) are still widely used for the reconstruction of defects pertaining to head and neck region, though free flaps are considered to be gold standard. The study was aimed to identify the risk factors involved in post - operative complications of PMMC Flap for oral subsites.

Methods

A total of 266 patients operated in an oncology institute over 2 years of time was evaluated based on their demographic data, pre and post-surgery details, post-operative flap morbidity were collected retrospectively from master case sheets from January 2022 to January 2024. Factors such as age, gender, stage of disease, diabetic status, and hypoprotenemia and radiation therapy were seen, analysed to find their relation in causing flap complications.

Results

Totally 266 patients were included for analysis and 16.9 % had major flap complications. On detailed analysis, it was seen that larger bipaddled flaps had higher flap complication rate, highest being wound infection.

Conclusion

PMMC Flap is a viable option for head and neck cancer reconstruction, specifically in cases where free microvascular flaps are not done routinely and patient presents with multiple comorbidities. Careful patient selection, pre – operative optimization, operating surgeon experience and post-operative care are contributing factors to reduce flap complications.