Reconstruction of intermediate sized mucosal defects with the pectoralis major myofascial flap.

An uncovered pectoralis major muscle flap (PMF) was utilized in 12 patients for reconstruction of mucosal defects of intermediate size. The PMF is nonhair-bearing and thinner and more flexible than the myocutaneous flap. Epithelialization of the PMF occurs slowly but results in a mucosal surface that is nonkeratinized and closely resembles normal. The paddle of the PMF contracts as much as 75% during healing. However, none of our patients developed deficits attributable to contracture of the flap, presumably because only modest-sized defects were repaired. The PMF is useful for reconstruction of intermediate-sized defects approximately 6 x 6 cm, defects that are too large to close with local flaps and tend to be too small to be closed conveniently with a bulky myocutaneous flap. Contracture of the PMF precludes its use for reconstruction of large defects.