Pectoralis myocutaneous flap for salvage of necrotic wounds
The authors have utilized six pectoralis major myocutaneous flaps in attempts to salvage extensive necrotic wounds of the pharynx and neck. The flap was employed in the following situations: massive necrosis of the entire neck skin with both carotid artery systems exposed, radiation necrosis of the neck skin with exposure of carotid artery, dehiscence of gastric pull-up from pharynx with resultant carotid exposure, failed trapezius flap in a radionecrotic oral cavity, and two cases of pharyngocutaneous fistula with extensive soft tissue necrosis. These flaps achieved healing in all cases. One death occurred 3 weeks following complete cutaneous healing secondary to a ruptured carotid pseudoaneurysm. One flap underwent total skin loss but the entirety of the muscle survived and the fistula was successfully closed with the back of the muscle being subsequently skin grafted. One case of dehiscence of the flap from oral mucosa resulted in a minor exposure of mandible with limited osteoradionecrosis controlled by topical means. This flap has performed extremely well in these precarious and difficult situations that previously may not have been salvageable. It has also been effective in abbreviating the required hospitalization and wound care. The authors conclude that the pectoralis myocutaneous flap should be the primary choice for the management of extensive postsurgical wound necrosis.
- Research Organization:
- Albany Medical College, NY
- OSTI ID:
- 5606233
- Journal Information:
- Laryngoscope; (United States), Journal Name: Laryngoscope; (United States) Vol. 95:2; ISSN LARYA
- Country of Publication:
- United States
- Language:
- English
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63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ARTERIES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BLOOD VESSELS
BODY
BODY AREAS
CARDIOVASCULAR SYSTEM
CAROTID ARTERIES
DIGESTIVE SYSTEM
FISTULAE
HEALING
INJURIES
NECK
NECROSIS
ORGANS
PATHOLOGICAL CHANGES
PHARYNX
RADIATION EFFECTS
RADIATION INJURIES
RECOVERY
RESPIRATORY SYSTEM
SKIN
WOUNDS