Arch Plast Surg.  2022 Jan;49(1):39-42. 10.5999/aps.2021.01368.

Reconstruction of a large chest wall defect using bilateral pectoralis major myocutaneous flaps and V-Y rotation advancement flaps: a case report

• Jo GY
• Yoon JM
• Ki SH

• KMID: 2524913
• DOI: http://doi.org/10.5999/aps.2021.01368

Abstract

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

Keyword

Pectoralis muscle / Thoracic wall / Neoplasms / Case reports