Use of the extended pectoralis major myocutaneous flap as a wrap-around for mediastinal tracheal repair. (December 2021)

• Record Type: Journal Article
• Authors: Tan, Grace Hui-Min; Ong, Boon-Hean; Kok, Yee-Onn; Tan, Bien-Keem
• Is Part Of: JPRAS open. Volume 30(2021)
• Page Start: 133
• Page End: 137
• Publication Date: 2021-12
• Subjects: Tracheo-esophageal fistula -- mediastinal tracheal defect -- flap repair -- pectoralis major myocutaneous flap; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.jpra.2021.07.009
• Languages: English
• ISSNs: 2352-5878

Abstract

Summary: Persistent tracheoesophageal fistulas requiring flap repair of the trachea in the mediastinum are uncommon. A 44-year-old man developed a 5 cm x 2 cm persistent posterior tracheal defect after failed tracheo-esophageal fistula repair. The defect was patch repaired using the de-epithelialized skin paddle of an extended pectoralis major flap tunneled into the mediastinum. The use of cross-field ventilation, second rib removal and an anterior tracheostomy slit were crucial for posterior tracheal repair. No major complication occurred. The patch repair with the de-epithelialized skin paddle of pectoralis major flap mucosalized in 2 weeks and the patient was discharged one month postoperatively. The extended skin paddle of the pectoralis major flap was a useful method for tracheal wrap-around reconstruction.