title: Reliability of the pectoralis major myocutaneous flap in reconstructive oral cancer surgery in developing countries: Our experience.
abstract: BACKGROUND
  Although free flaps are nowadays considered 'Gold standard' of head and neck reconstruction, pectoralis major myocutaneous (PMMC) flap is still popular among many reconstructive cancer surgeons in developing countries for its many advantages and also due to lack of resources for free flaps in most of the centers, large number of cancer patients with poor nutritional status and economic condition. However, many studies have reported high complication rate in PMMC flap. So, the purpose of our study was to evaluate the reliability of PMMC flap.
  
  
  METHODS
  Within a span of 2 years, 20 reconstructions were done with PMMC flaps in patients with oral cancer and they were followed for a period of 1 year. Documentation was done for patient demographics, site of lesion, duration for reconstruction, occurrence of complications, etc.
  
  
  RESULTS
  Among 17 males and 3 female patients, complications developed in 4 males and all female patients (total 7 patients, overall 35%). Flap-related complications were - one major (5%) and six minor (30%), which were comprised of three orocutaneous fistula (15%), three partial flap loss (15%), two marginal necrosis (10%), and one donor site necrosis (5%). Total necrosis was nil in our study. All the complications were managed conservatively except the patient with major complication which required intervention. Final cosmetic and functional outcome was acceptable in majority of patients.
  
  
  CONCLUSIONS
  PMMC flap is still 'workhorse' of reconstruction in head neck cancer patients in developing countries and can be used effectively with acceptable morbidity.
authors.affiliation: Assistant Professor, Department of Dental Surgery, SMIMS, Gangtok, India.
authors.forename: Atanu
authors.initials: A
authors.lastname: Bhanja
authors.affiliation: Professor & Head, Department of Dental Surgery, SMIMS, Gangtok, India.
authors.forename: D S J
authors.initials: DS
authors.lastname: D'Souza
authors.affiliation: Professor & Head, Department of Plastic and Reconstructive Surgery, NRSMCH, Kolkata, India.
authors.forename: Collin
authors.initials: C
authors.lastname: Roy
authors.affiliation: Professor, Department of Maxillofacial Surgery, R. Ahmed Dental College & Hospital, Kolkata, India.
authors.forename: R N
authors.initials: RN
authors.lastname: Poddar
keywords: Mouth neoplasms; Myocutaneous flap; Pectoralis muscles; Postoperative complications; Reconstructive surgical procedure