Clinical Study of Versatile Flaps for Reconstruction of 100 Post Bite Resection Defects: Proclivity Towards PMMC Flap

Introduction: In India head and neck cancer patients usually present in the advanced stage, requiring extensive resections with complicated reconstructions. The goal of reconstructive surgery is to provide functional ability, restoration of form and aesthetics. Various reconstructive techniques are local aps, regional aps and free vascularised aps; each with its inherent advantages and shortcomings. Although microvascular technique is the standard of care, but its use is limited by availability of expertise and resources in developing world. The common alternative in these cases is the use of the pectoralis major myocutaneous ap (PMMC). Our article highlights the experiences and outcomes associated with PMMC ap and its availability in resource constrained facility. Methods: A retrospective analysis of 100 patients was conducted; diagnosed with oral squamous cell carcinoma and underwent complex resection from 2018 to 2021 in Department of Surgical oncology, Balco medical centre, Naya Raipur. A total of 58 patients underwent reconstruction with PMMC ap, rest with free microvascular aps. All the patients were followed up for an average period of 1 year leading to the assessment and outcomes of PMMC ap. Results: A total of 100 patients were reviewed; of these, 83 (84.69%) were male, with median age of 36.14 (31-40 years) and rest were female (16.31%) with the median age of 33.33 (51-60 years). Every tumour was located in the oral cavity. PMMC aps were used to cover both mucosal and skin defects. The overall complication rate involving partial ap necrosis was less in PMMC aps in comparison to other reconstructive aps. The results were in favour of PMMC aps; decreased operative time, minimal cost and causation of additional donor site morbidity. Conclusion: PMMC ap can be a reliable and versatile option for advanced oral malignancies with an excellent reach to face, oral cavity and neck region especially in patients with poor status with any coexisting chronic illness. It can be considered as a valid alternative to free ap for repair of bony defects, especially in patients with low socioeconomic corridor like India.