The pectoralis major flap, often referred to as a PEC flap, is a surgical technique that utilizes the pectoralis major muscle, sometimes with overlying skin and potentially underlying ribs, for reconstructive purposes. Its blood supply originates from the pectoral branch of the thoracoacromial artery, which is located superiorly.
In more detail:
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Composition: The flap typically consists of the pectoralis major muscle. Skin (a skin paddle) can be included if needed. In some cases, underlying ribs are incorporated.
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Blood Supply: It relies on the pectoral branch of the thoracoacromial artery for its primary blood supply. This axial blood supply makes the flap reliable.
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Use Cases: The PEC flap is frequently employed in head and neck reconstruction, especially after ablative surgery for cancer. It can also be used to cover defects in the chest wall.
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Advantages:
- Reliable Blood Supply: The axial blood supply ensures flap viability.
- Large Tissue Volume: The pectoralis major muscle provides a substantial amount of tissue for reconstruction.
- Proximity to Head and Neck: The muscle's location makes it convenient for reconstructing defects in the head and neck region.
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Disadvantages:
- Bulkiness: The flap can sometimes be bulky, which may be undesirable in certain cosmetic reconstructions.
- Donor Site Morbidity: There can be functional deficits in the donor site (chest wall) such as weakness.
- Visible Scar: A scar will be present on the chest wall.
