Marx R E, Smith B R
Division of Oral and Maxillofacial Surgery, University of Miami School of Medicine, FL 33136.
J Oral Maxillofac Surg. 1990 Nov;48(11):1168-80. doi: 10.1016/0278-2391(90)90533-8.
The pectoralis major myocutaneous flap is the most commonly employed muscle skin transfer used in soft-tissue reconstruction of defects of the upper neck and jaw region. This article presents conceptual and technical changes in the development of the pectoralis major myocutaneous flap that preserve a greater vascular pedicle and enhance the flap's arc of rotation. Data from 54 consecutive cases using this modified approach show a reduction in complications, a greater range of use, and consistent healing in radiated and nonradiated tissues without requiring sectioning or removing the clavicle or causing significant chest deformities. These modifications have produced a more predictable transfer compared with other reported techniques.
胸大肌肌皮瓣是上颈部和颌面部缺损软组织重建中最常用的肌皮转移瓣。本文介绍了胸大肌肌皮瓣在发展过程中的概念和技术变化，这些变化保留了更长的血管蒂并增加了皮瓣的旋转弧。连续54例采用这种改良方法的病例数据显示，并发症减少，应用范围更广，放疗和未放疗组织均能顺利愈合，无需切断或切除锁骨，也不会导致明显的胸部畸形。与其他已报道的技术相比，这些改良使转移更可预测。
