Can Lateral Thoracic Artery Preservation Improve Results in Large PMMC Flaps? - Our Experience of 61 Cases from Northern India.

IF 0.1 0 RELIGION Review & Expositor Pub Date : 2024-02-01 Epub Date: 2023-08-04 DOI:10.1007/s12070-023-04123-3
Pranav Mohan Singhal, Pinakin Patel, Kama Kishor Lakhera, Agil Babu, Aishwarya Chatterjee, Suresh Singh, Bhoopendra Singh Gora, Naina Kumar Agarwal
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Abstract

Introduction: Pectoralis major myo-cutaneous (PMMC) flap continues to be a widely used tool to reconstruct oral cavity defects. But an unreliable and unstable vascular supply can lead to complications like flap loss, Oro-cutaneous fistula and wound dehiscence. Preservation of the lateral thoracic artery (LTA) has been suggested to improve the vascularity of the skin paddle. The present study aspires to compare the complications and flap related outcomes after preserving or sacrificing the LTA while reconstructing oral cavity defects with bi-folded PMMC flap. Materials and Methods: Retrospective analysis of the data of 61 male patients who were reconstructed with bi-folded PMMC flaps between January 2022 and September 2022 was done. 36 patients were reconstructed using a PMMC flap where the LTA was sacrificed, whereas in 25 patients the LTA was preserved. Data was analyzed in terms of patient factors and flap related complications. Results: The overall complication rate including major/minor complications was 44.26% with flap detachment at 22.95% being the commonest complication observed. 13.11% patients developed an Oro-cutaneous fistula and partial and complete flap loss were seen in 9.83% and 4.91% respectively. LTA preservation was significantly associated with only decreased flap detachment rates (p value < 0.05). No significant association was noticed between other flap related complications and LTA preservation. Conclusion: Reconstructing larger defects with a PMMC flap where the LTA is preserved can help improve the vascularity of the flap and decrease various major/minor flap related complications.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-023-04123-3.

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保留胸外侧动脉能否改善大型 PMMC 皮瓣的效果?- 印度北部 61 例病例的经验。
简介:胸大肌肌皮瓣(PMMC)一直是重建口腔缺损的广泛应用工具。但不可靠和不稳定的血管供应会导致皮瓣脱落、口腔瘘和伤口裂开等并发症。有人建议保留侧胸动脉(LTA)来改善皮瓣的血管供应。本研究旨在比较使用双折PMMC皮瓣重建口腔缺损时保留或牺牲LTA后的并发症和皮瓣相关结果。材料与方法:对2022年1月至2022年9月期间使用双折叠PMMC瓣重建的61名男性患者的数据进行了回顾性分析。36例患者使用PMMC皮瓣进行了重建,其中牺牲了LTA,而25例患者保留了LTA。对患者因素和皮瓣相关并发症进行了数据分析。结果:包括主要/次要并发症在内的总体并发症发生率为 44.26%,其中最常见的并发症是皮瓣脱落,占 22.95%。13.11%的患者出现口-皮瘘,9.83%和4.91%的患者出现皮瓣部分和完全脱落。保留 LTA 与皮瓣脱落率下降有明显关系(P 值 结论):用保留LTA的PMMC皮瓣重建较大的缺损有助于改善皮瓣的血管性,减少各种主要/次要皮瓣相关并发症:在线版本包含补充材料,可在 10.1007/s12070-023-04123-3。
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Review & Expositor RELIGION-
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