Management of deltopectoral flap failure using a three-stage revision reconstruction: a case report

Abstract Although deltopectoral flap failure is uncommon, its management can be difficult. This report presents a case of deltopectoral flap failure successfully rescued by a three-stage revision reconstruction using the postdebridement flap. A 59-year-old patient presented with a pharyngocutaneous...

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Bibliographic Details
Published in:Journal of surgical case reports 2021-04, Vol.2021 (4), p.rjab143
Main Authors: Chotipanich, Adit, Wongmanee, Sombat
Format: Article
Language:English
Subjects:
Case Report
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Summary:Abstract Although deltopectoral flap failure is uncommon, its management can be difficult. This report presents a case of deltopectoral flap failure successfully rescued by a three-stage revision reconstruction using the postdebridement flap. A 59-year-old patient presented with a pharyngocutaneous fistula due to radionecrosis and subsequently underwent a medially based deltopectoral flap reconstruction for fistula closure. Unfortunately, this operation was unsuccessful because the flap developed necrosis at its distal tip, and the postdebridement flap could not be directly placed on the defect because of its shorter length. A subsequent revision operation successfully closed the fistula using a three-stage reconstruction with the postdebridement flap. Although this three-stage technique can avoid the morbidity associated with additional flap harvesting and can greatly extend the distance to the recipient, it also requires more time to heal and more operations than simply harvesting a new flap.
ISSN:2042-8812
2042-8812
DOI:10.1093/jscr/rjab143