Clinical analysis of factors related to the viability of pectoralis major myocutaneous island flap

In the present study, we analysed patient characteristics and other factors related to flap viability in 19 patients who underwent reconstructive surgery using a pectoralis major myocutaneous island flap in our department over 6+ the past eight years. In these 19 patients (15 males and 4 females), the flap was used on the luminal side of the oral cavity and oropharynx after radical surgery for the treatment of carcinoma of the tongue (10 cases), carcinomas of the oral floor and gingiva (5 cases), and oropharyngeal carcinoma (1 case). Wound complications in the island flap or cervical skin incision site occurred in 11 out of 19 patients, and included partial necrosis of the island flaps (8 cases), dehiscence of the cervical skin incision site (7 cases), dehiscence of the island flap margin (3 cases) and so on. All four of the patients with diabetes mellitus had some wound complications. A comparison of blood data a month before surgery patients with and without wound complications, revealed the mean value of total protein to be significantly lower in the group with wound complications than that in the group without wound complications. A comparison of blood data one month after surgery revealed a significantly higher leukocyte count in the group with wound complications than in the group without wound complications. When a comparison of the incidence of wound complications was made between the group with radiation therapy and that without radiation therapy, the former group showed a higher incidence of complications in the cervical skin incision site than the latter group did, in cases of cervical irradiation. (author)