유리피판 시대의 대흉근피판의 역할

• 영문명: The Role of Pectoralis Major Myocutaneous Flap in the Era of Free Flap
• 발행기관: 대한두경부종양학회
• 저자명: 최은창(Eun Chang Choi) 김철호(Chul Ho Kim) 김세헌(Se Heon Kim) 김영호(Young Ho Kim) 김광문(Kwang Moon Kim)
• 간행물 정보: 『대한두경부종양학회지』제17권 제2호, 190~193쪽, 전체 4쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2001.11.30

영문 초록

Background and Objectives: Reliable and versatile free flap has become a mainstay in reconstruction of the head and neck. But until now pectoralis major myocutaneous flap (PMMCF) as workhorse is useful and has some advantages such as good viability, one-stage reconstruction and carotid protection. The objective of this study was to review the role and indication of PMMCF in this era of potent free flaps for head and neck reconstruction. Patients and Methods: Sixty one PMMCF and one hundred forty six free flaps used for head and neck reconstruction between 1991 and 2001 were reviewed retrospectively. We compared the applied sites of flap, the flap failure rate and complications. Results: Contrary to the free flap, use of PMMCF has gradually decreased after the middle of 1990s. PMMCF were mainly used for mucosal defect(33cases, 54.1%) and cervical skin defect(22cases, 36.1%) and free flap were mainly used for mucosal defect(129cases, 88.4%). In point of use of PMMCF according to years, from 1991 to 1997, 30cases(70%) are used to reconstruct mucosal defect and 12cases(29%) are used to reconstruct skin defect. But from 1998 to 2001, only 2cases(10.5%) are used to reconstruct mucosal defect and 13cases(68.4%) are used to reconstruct neck skin defect. In case of free flap, from 1991 to 1997, 41cases (87%) are used to reconstruct mucosal defect and from 1998 to 2001 88cases(89%) are used as same purpose. Three major necrosis (more than 50%) deveolped in 61 PMMCF (4.9%) and three major necrosis developed in 146 free flaps(2.1%). Conclusion: PMMCF is no longer flap of choice for primary reconstruction but it is a still one of a good tool in some head and neck reconstruction such as covering single wide defect of face or neck skin, back-up procedure of free flap, postoperative status, treatment of pharyngocutaneous fistula and covering vital structure.

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키워드

대흉근 피판 유리피판술 두경부재건 Pectoralis major myocutaneous flap Free flap Head and neck reconstruction