Application of the Deltopectoral Flap in the Reconstruction of Large Head and Neck Defects: Two Case Reports

Abstract

Introduction The deltopectoral flap was first described by Aymard in 1917 for nose reconstruction but became prominent after 1965 when Bakamjian began to use it for pharyngoesophageal reconstructions.

Methods This study is a retrospective analysis of patients undergoing surgery in 2022. Among them, we selected two patients subjected to cervicofacial reconstruction with deltopectoral flap. Their assessment included age, gender, lesion etiology, defect location, number of surgical procedures performed per patient, postoperative complications, and the personal satisfaction of the subjects.

Results Patients underwent cervicofacial reconstruction after tumor resection, and both required more than a surgical time for pedicle refinement and transection. One patient had a defect in an operative wound after repositioning the remnant in the donor area leading to a hypertrophic and hypochromic scar in the surrounding region. In these two cases, the deltopectoral flap supplied thin skin, with similar texture and color to the cervicofacial region, a consistent and predictable pedicle, good defect cover, flap safety and reproductivity, a fast surgical technique, and no need for patient positioning change during the procedure.

Conclusions The deltopectoral flap remains a significant therapeutic option in reconstructing large head and bone defects despite the advent of microsurgery. It allows for efficient and reliable tissue transfer with small deformities in the donor area, allowing an acceptable aesthetic reconstruction.

Descriptors

plastic surgery procedures - head and neck neoplasms - surgical flaps - therapeutics - postoperative complications

Authors' contribution

JPGS-C: data analysis, interpretation, or both, statistical analysis, data collection, study conception and design, methodology, writing – original draft preparation, review and editing, visualization; AFA, JLTM, MAVB: data analysis, interpretation, or both, data collection; MJC: data analysis, interpretation, or both, final manuscript approval, writing – review and editing, supervision; RLF: data analysis, interpretation, or both, final manuscript approval, supervision.

Publication History

Received: 06 January 2024

Accepted: 16 November 2024

Article published online:
04 February 2025

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