Reverse Myo Fascial Pectoralis Major Flap in Chest Reconstruction: A Case Report

The pectoralis major myocutaneous flap and myofascial flap variation are utilized in a large variety of head, neck and chest reconstructive procedures that can include coverage of mucosal and/or cutaneous defects. The myofascial flap variation carries no skin paddle and is utilized primarily to close small mucosal defects, to protect major vascular structures and to support primary wound closures in a patient at increased risk of breakdown (prior radiation, diabetic, weight loss). This is a Type V Axial Flap in blood supply [ Mathes and Nahai]. This flap has a dominant pedicle and many segmental blood vessels. When we elevate the normal flap, we sacrifice segmental blood vessels and save the dominant pedicle In the reverse flap is sacrificed the dominant pedicle and all the flap is based in segmental blood vessels.