Costal osteomyelitis after pectoralis major myocutaneous flap use in head and neck reconstruction.

Costal osteomyelitis and chondritis are rare complications of PMMF usage. They probably represent a secondary complication of a donor-site infection. This diagnosis must be considered in cases of PMMF donor-site infections, which fail to resolve with local wound care and antibiotics. Antibiotic coverage in these cases should be taylored to culture results, while having broad gram-positive activity. Workup of these patients should include CT and biopsy to rule out a neoplastic process.