Badamutlang Dympep, TM Balakrishnan, and J Jaganmohan
Madras Medical College and Rajiv Gandhi Government General Hospital, India
Scientific Tracks Abstracts: Surgery Curr Res
Background: Despite the popularity of microvascular surgery, the pedicled Pectoralis Major Myocutaneous flap continues to be the workhorse for head and neck reconstruction. This is a large, bulky flap recruiting unnecessary tissues. Thinning of the flap is difficult. With the advent of perforator propeller flap, the pectoral axis of the thoracoacromial stem is explored so that a super thin flap can be used for head and neck reconstruction. In this study, we are demonstrating that it is possible to harvest such a thin flap based on the pectoral axis of thoracoacromial stem for the more aesthetic reconstruction of head and neck defects. Aim: Cadaveric injection and dissection study to establish the feasibility of harvesting the pectoral perforator flap with clinical application in head and neck reconstruction. The aim of the clinical study was to assess the outcome of pectoralis perforator flap for head and neck reconstruction. Materials and methods: 60 specimens in 30 preserved cadavers were examined after dye injection. Diluted red lead oxide injected into the axillary artery and methylene blue injected into veins. After 24 hours overnight refrigeration, dissection was done the next day. A small paddle of skin was marked on the inferior-medial aspect of the chest. The perforator was identified from the pectoral branch of pectoralis major. Peri-perforator dissection was carried out by splitting the muscle fibers vertically into the source vessel on the sub-epimysial plane of pectoralis major until a long pedicle is obtained. The author had performed 10 cases of head and neck reconstruction using the pectoral perforator flap. Observation and results: We have shown the feasibility of perforator dissection and how to harvest a pectoral perforator flap for interpolation into the head and neck defects. Conclusion: The pedicled pectoral perforator flap is an added tool in the armamentarium of plastic surgeons dealing with head and neck reconstruction.
Badamutlang Dympep is a Ist year Resident at the Department of Plastic Surgery. She hails from the remote North-Eastern part of India where there is limited medical accessibility. Under the training of Professor J Jaganmohan and the faculty of MMC, Chennai, she hopes to bring world-class health care to the people in the remote areas, especially in Plastic and reconstructive surgery. Newer and improved methods of reconstructive surgery are conceived out of the vast experience in Plastic Surgery by the faculty in MMC. Through this conference, she will share their research work.
E-mail: badadympep@gmail.com
