title: Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome.
abstract: OBJECTIVE
  Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection.
  
  
  METHODS
  Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC).
  
  
  METHODS
  Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion.
  
  
  RESULTS
  There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (p = 0.02) and with reconstruction failure (p < 0.001). Previous oncological treatment negatively influenced the reconstruction success (p = 0.04).
  
  
  CONCLUSIONS
  Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.
authors.affiliation: FMABC, São Bernardo do Campo, São Paulo, Brazil.
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Pinto
authors.forename: Carina Rosa
authors.initials: CR
authors.lastname: Malena
authors.forename: Christiana Maria Ribeiro Salles
authors.initials: CM
authors.lastname: Vanni
authors.forename: Fábio de Aquino
authors.initials: Fde A
authors.lastname: Capelli
authors.forename: Leandro Luongo de
authors.initials: LL
authors.lastname: Matos
authors.forename: Jossi Ledo
authors.initials: JL
authors.lastname: Kanda
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006257:Head / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D009336:Necrosis; D010369:Pectoralis Muscles / Q000637:transplantation*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D013524:Surgical Flaps / Q000009:adverse effects / Q000473:pathology; D016896:Treatment Outcome