Dec 31, 2016 the pectoralis major is the most commonly used flap as a backup for repair and reconstruction following the loss of free flap reconstruction. The pectoralis major myocutaneous flap pmmf is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is also associated with a high incidence of complications. Originally simple holes, the modern form is a hinged and often springloaded panel or flexible flap, and some. The slotted flap was a result of research at handleypage, a variant of the slot that dates from the 1920s, but was not widely used until much later. The pectoralis major myocutaneous flap pmmf is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is. Works by apianus are among the earliest examples of rotating flap books that have. A history of popup books, books with interchangeable figures and other. The purpose of the study is the evaluation of the reliability and indication of this flap in reconstructive. The postop pictures were taken 1 year after her mastectomies. Our priority is to fulfil all existing orders whilst ensuring the health and wellbeing of our colleagues and customers alike. A pet door or pet flap also referred to in more specific terms, such as cat flap, cat door, dog door, or doggy door is a small opening to allow pets to enter and exit a building on their own without needing a human to open the door. Keywords head and neck cancer intraoral cancer temporal bone resection myocutaneous flap reconstruction pectoralis major chest wall orbital exenteration.
All patients who received dp flap reconstruction surgery at the department of surgery, queen. An important new flap for head and neck reconstruction by bryan c. The proximal tendon is cauterized to detach it from the ischiopubic ramus and the distal muscle is transected with cautery near the insertion or at the distal wound, depending on the length needed. His printing business, begun in 1877, was capable of producing works by all of the major processes of the time. The hemisoleus rotational flap provides a novel superior. With coverage of nearly twice the number of flaps as the previous edition, flaps and reconstructive surgery, 2 nd edition provides trainees and practicing surgeons alike with the detailed, expert knowledge required to ensure optimal outcomes. Anatomy of pectoralis major the pectoralis major is a flat triangular fan shaped muscle lying on the anterior and superior aspect of the chest wall. A reliable and simple technique involving the use of pectoralis major muscle flaps is described for the closure of sternal and costal cartilage defects caused by debridement for chronic osteomyelitis following median sternotomy. Lifttheflap questions and answers about our world lifttheflap. The history of flap surgery dates as far back as 600 bc, when sushruta samita described nasal reconstruction using a cheek flap. In ear reconstruction, the thinner fascial flap by itself is preferable. Pectoralis major myocutaneous flap and myofascial flap see also. Use of pectoralis major myocutaneous flap for resurfacing the. Now in its thoroughly updated third edition, this classic work is the most comprehensive reference ever published on surgical flaps for reconstructing defects in the head and neck.
The pectoralis major myocutaneous pmmc flap has always been considered the workhorse flap for oral, head, and neck reconstruction. Get cozy and expand your home library with a large online selection of books at. Only a portion of the muscle is used for flap reconstruction. Nippleareola reconstruction using the double opposing flap technique surgical technique similar to most local flaps, double opposing flaps should be created after the projection of the new breast is stabilized during the second or third breast reconstruction. Pectoralis major flap for head and neck reconstruction.
The department continued to reinforce academic exchanges and to promote training and medical research with institutes in mainland china. Pectoralis major muscle flaps for closure of sternal defects. Originally simple holes, the modern form is a hinged and often springloaded panel or flexible flap, and some are electronically controlled. Pectoralis major myocutaneous flap is a soft tissue reconstructive surgical procedure that provides oral lining and facial cover of soft tissue defects. A slit was made in the quad tendon proximal to the rupture, and the flap was brought through the slit in the tendon. Department of otorhinolaryngology, head and neck surgery. The pectoralis major myocutaneous flap pmmf is a commonly used flap for reconstructive head and neck surgery. Feb 27, 2011 the pectoralis major myocutaneous flap pmmf is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is also associated with a high incidence of complications in addition to its large bulk. The aim was to evaluate the feasibility of pectoralis major myocutaneous pmmc flap in reconstruction of defects in the head and neck region. Detailed case studies illustrate how to optimize every aspect of care for the reconstructive surgery patient, including the postoperative period and longterm followup. Q1 flap book latitude, longitude, equator, prime meridian q1 practice page students will color in geographical features q1 assessment with rubric including locating greece q2 flap book rocky mountain range and appalachian mo. In 1979, ariyan was the first to describe the use of the pmmc flap in head and neck reconstruction. A split flap that slides backwards, before hinging downward, thereby increasing first.
Another technique, the delayed flap, involves undermining portions of the flap without moving it from the donor bed. Some flaps use multiple slots to further boost the effect. All patients who received dp flap reconstruction surgery at the department of surgery, queen mary hospital, between 1999 and 2011 were recruited. The pectoralis major flap comprises the pectoralis major muscle, with or without overlying skin, and may include the under lying ribs. Pectoralis major flap vula university of cape town.
Optimization of 2d flap geometry using matlab and fun3d gregory d. Perssonelli editorial comment this flap is based on the same principle as the temporoparietal fascial flap. Novelty books in the childrens books collection koninklijke. Pectoralis major myocutaneous flap in head and neck reconstruction by dr. Mar 02, 2015 pectoralis major myocutaneous flap in head and neck reconstruction 1. This unit correlates with the georgia geography standards.
The origins of deltopectoral flaps and the pectoralis major. A docking trench in the patella was created by using a rongeur without violating the patellar implant. British journal of plastic surgery 1980, 33, 318 323 0007122680. Pectoralis major myocutaneous flap and myofascial flap iowa. Improve your surgical skills by following this elearning module. The layout and flaps make the book fun for children, and my 4 year old soaks up the facts, regularly.
Ariyan was among the first to use this pedicle flap for head and neck defects 1,2. The germanlanguage volume, digitised for the first time, uses paper flaps to demonstrate the different layers of the human body. Home october 2011 volume 128 issue supplement 4s pectoralis major turnover versus advancement flap for sterna. Pectoralis major myocutaneous flap and myofascial flap. Aponeurotic galeal flaps can be used for the correction of. Ariyan7,8,9 introduced the pectoralis major myocutaneous flap to head and neck surgery. This is especially important if the mastectomy was done through a central scar and the scar is completely adherent to the pectoralis major. Pectoralis major turnover versus advancement flap for sterna. The myofascial flap variation carries no skin paddle and is utilized primarily to close small mucosal defects, to protect major vascular structures. Nippleareola reconstruction using the double opposing flap. Evaluation of the pectoralis major flap for reconstructive. Find your childs next best read in our childrens books store. The muscle is a medial rotator of the arm and, in combination with the muscles of the posterior axillary fold, particularly the latissimus dorsi, a powerful adductor of the arm. Indications the pectoralis major myocutaneous flap and myofascial flap variation are utilized in a large variety of head and neck reconstructive procedures that can include coverage of mucosal andor cutaneous defects.
Honorary assistant plastic surgeon, alfred hospital, melbourne, australia it is the authors. Pectoralis major myocutaneous pmmc flap, based on the thoracoacromial artery, whose first description is commonly attributed to ariyan in 1979 who exhaustively described the technique and its anatomical basis 1, was however reported in 1977 by at least two authors 2 3. Learn about the pectoralis major flap, an online 3dvideobased course, accredited by the royal college of surgeons of england. Nippleareola reconstruction using the double opposing. He described raising a medially based fasciocutaneous flap from the shoulder skin, which was then tubed and used for staged nasal reconstruction. Nowadays, free flaps are more common due to improved microsurgical techniques, but in several cases the pmmf still has its advantages, including its proximity to the head and neck, the. The pectoralis major is the most commonly used flap as a backup for repair and reconstruction following the loss of free flap reconstruction. The pectoralis major myocutaneous flap pmmf is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is also associated with a high incidence of complications in addition to its large bulk. In clearly organized chapters, internationally recognized surgeons describe and illustrate every clinically proven flap option available for repairing every routine and unusual defect. The serratus anterior muscle takes origin from the lateral scapula and fans anteriorly as it inserts into the first nine ribs. Prepectoral revision breast reconstruction for treatment. Contemporary role of pectoralis major regional flaps in head. Since the beginning of the 1980s, until the end of the 1990s, the indications for pectoralis major flaps have progressively broadened, made possible by the unprecedented reconstructive possibilities they offered, which were further increased by the above cited.
Dept of periodontics periodontal flaps presented by, shiji margaret d. Case example of pectoralis myocutaneous flap general considerations. A novel technique of raising a pectoralis major myocutaneous flap through the skin paddle incision alone article in journal of surgical oncology 862. Howe1 georgia institute of technology, atlanta, ga, 30332 this paper describes work done in the process of creating a workable system for the optimization of twoelement highlift airfoil. Evaluation of the pectoralis major flap for reconstructive head and. In addition, some cases had fat injected prior to the revision to ensure adequate flap thickness and ease the dissection and separation of the pectoralis major from the overlying skin envelope. The study also outlines types of other tissue required, the donor site morbidity and the technical details of the operative procedure. Usborne history books help children learn about britains past, and that of the wider world, with flap books and sticker books packed with historical detail, and. In its long history, the pectoralis major flap has seen alternating indications. The department of otorhinolaryngology, head and neck surgery officially formed in august and became a full academic department of faculty of medicine, the chinese university of hong kong. The flap was then passed from the posterior compartment to the anterior compartment through a medial subcutaneous incision. Contemporary role of pectoralis major regional flaps in.
Definition a periodontal flap is a section of gingiva andor mucosa surgically separated from the underlying tissues to provide visibility and access to the bone and root surface. Three papers given in memory of jocelyn toynbee newnham college, cambridge s. Pectoralis major myocutaneous flap in head and neck surgery. Medial sural artery perforator free flap msap a medial sural artery perforator free flap is also known as an msap flap.
The muscle is then freed of all soft tissue attachments except for the pedicle. Demographic data, indications for surgery, defect for. The origins of deltopectoral flaps and the pectoralis. Flappe is a term from the 16th century denoting something that hangs broad and loose, attached by only one side.
This elearning course provides a step by step approach. Pectoralis major turnover versus advancement flap for. Pectoralis major myocutaneous flap in head and neck reconstruction 1. No bone grafts, omentum flaps or skin grafts have been needed in more than 20 patients. It has been considered for decades the workhorse for head and neck reconstruction, and is still. In unilateral breast reconstructions, the position of the. The history of flap surgery dates as far back as 600 bc, when sushruta samita described nasal reconstruction using a. Keywords head and neck cancer intraoral cancer temporal bone resection myocutaneous flap reconstruction pectoralis major. Includes highquality illustrations of regional anatomy, flap anatomy, and stepbystep flap dissections, as well as clear photographs demonstrating successful reconstructions. Howe1 georgia institute of technology, atlanta, ga, 30332 this paper describes work done in the process of creating a workable system for the optimization of twoelement highlift airfoil design based on a fixed cruise configuration baseline.
They have added flaps, revolving parts, and other movable pieces to. The pectoralis major myocutaneous flaps described by ariyan and baek are a hybrid of conleys laterally based deltopectoral flap and huestons inclusion of the pectoralis major muscle in the skin flap. Use of pectoralis major myocutaneous flap for resurfacing. A split flap that slides backwards, before hinging downward, thereby increasing first chord, then camber. Pectoralis major myocutaneous flap in head and neck. Medial sural artery perforator free flap msap british. Another wonderful book by usborne, full if fascinating facts. Hueston was the first to combine a skin flap and pectoralis major muscle for repair of the large defects of the chest wall. Pectoralis major myocutaneous flap in head and neck reconstruction. She underwent bilateral latissimus flap and tissue expander reconstruction and the expanders were exchanged for 600 cc gel implants. Pharyngeal peconstruction surgery by konstantinos apostolopoulos. Honorary assistant plastic surgeon, alfred hospital, melbourne, australia it is the authors belief that the. Q1 flap book latitude, longitude, equator, prime meridian q1 practice page students will color in geographical features q1 assessment with rubric including locating greece q2 flap book rocky mountain range and appalachian mountain range q2 practice page students will color in geographical features q2 assessment with. It includes chapters and expert commentaries from more than 100 authors and worldrenowned leaders in the field, while brandnew cases and high.
Established uses include esophageal luminal augmentation, reconstruction of oral cavity and oropharyngeal defects, lateral. Feb 18, 2020 flappe is a term from the 16th century denoting something that hangs broad and loose, attached by only one side. The volume is extensively indexed and organized by anatomic region, and chapters follow a uniform format that clearly presents all the information needed on each flapindications, anatomy, blood supply, surgical techniques, complications, safeguards to keep in mind, and advantages and disadvantages of the flap. The pectoralis major myocutaneous pmmc flap has been considered the workhorse reconstructive flap for head and neck defects since its initial description in the late 1970s. The term flap originated in the 16th century from the dutch word flappe, meaning something that hung broad and loose, fastened only by one side. The degree of paralysis of pectoralis major may be helpful in gauging the extent of a brachial plexus injury p. The evolution of the flap courses tortuously over the centuries, illustrating the intense drive for humans to reconstruct deficient anatomy and create form where originally absent. Optimization of 2d flap geometry using matlab and fun3d. The past tense of flap is flapped the thirdperson singular simple present indicative form of flap is flaps the present participle of flap is flapping the past participle of flap is flapped.
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