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>Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome
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Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome
CONTEXT AND OBJECTIVE: Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection. DESIGN AND SETTING: Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC). METHODS: Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion. RESULTS: There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (p = 0.02) and with reconstruction failure (p < 0.001). Previous oncological treatment negatively influenced the reconstruction success (p = 0.04). CONCLUSIONS: Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.
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机译：背景与目的：带蒂皮瓣在癌症治疗中心，特别是在发展中国家和新兴国家中，起着重要的作用。这项研究的目的是确定可能导致并发症并影响使用胸大肌肌皮瓣（PMMF）进行重建以进行癌症切除后头颈部缺损修复的最终结果。设计与设置：在ABC医学院（FMABC）的Ensino Padre Anchieta医院进行横断面研究。方法：回顾了58例使用PMMF重建头颈部缺损的患者的数据。重建的最终结果（成功或失败）和观察到的并发症与患者的年龄，重建区域，疾病阶段，先前的肿瘤治疗和输血需求有关。结果：没有皮瓣总丢失。重建成功率为93.1％。皮瓣相关并发症发生率为43.1％，其中一半被认为是严重的。大多数并发症均已成功治愈。源于下咽的缺陷与主要并发症的发生（p = 0.02）和重建失败（p <0.001）相关。先前的肿瘤治疗对重建成功产生负面影响（p = 0.04）。结论：由于已知发生严重并发症和重建失败的危险因素，因此重要的是要留意技术细节并为病情更为严重的患者提供仔细的临床支持，以便使用PMMF可获得更好的效果。
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