Complications following reconstruction with the pectoralis major myocutaneous flap: the effect of prior radiation therapy.

Over the past 5 years, 40 patients with head and neck cancer underwent pectoralis major myocutaneous flap (PMMF) reconstruction following radical ablative surgery. Twenty-three patients received prior radiation therapy (55 to 70.2 Gy), while 17 patients had no radiation preoperatively. Thirty-five percent of the irradiated patients had flap-related complications, compared to 47% of the nonirradiated patients (P = .52, not statistically significant [NSS]). There were no reoperations and no operative deaths in either group. There was 1 fistula in each group, both of which closed with conservative management. The PMMF for head and neck reconstruction is well tolerated following radiation therapy and has shown comparable morbidity in patients who have not undergone prior radiation.