Yadranko Ducic1, Jesse E Smith. 1. Department of Otolaryngology, University of Texas Southwestern Medial Center, Dallas, TX 76104, USA. yducic@aol.com
Abstract
OBJECTIVE: To evaluate prospectively the feasibility and utility of adding a cervical extension to the standard deltopectoral flap. We postulated that this cervicodeltopectoral (CDP) flap will allow for single-stage reconstruction of large defects of the anterolateral face and neck. METHODS: As is the case with the deltopectoral flap, the CDP flap is based on the perforating branches of the internal mammary artery. However, the superior and posterior limbs of the CDP flap are not limited by the clavicle and the deltoid muscle. Instead, they extend in a subcutaneous tissue plane to the margins of the neck or facial defect and transfer the entire intervening skin bridge with the deltopectoral flap. RESULTS: Eighteen patients underwent closure of complex cutaneous defects of the face and neck with the CDP flap. We found no evidence of flap loss in any of these patients. Twelve patients had received preoperative radiation therapy encompassing the cervical extension of the CDP flap. No evidence of adverse healing was noted in this subset of patients. CONCLUSIONS: The CDP flap may represent an alternative in the surgical treatment of various cutaneous defects of the face and neck. It allows for single-stage, reliable reconstruction of these defects. The transfer of intervening cervical skin in conjunction with the deltopectoral flap provides for a more aesthetically pleasing reconstruction, as skin immediately adjacent to the defect is more closely related to the excised skin in terms of color and texture.
OBJECTIVE: To evaluate prospectively the feasibility and utility of adding a cervical extension to the standard deltopectoral flap. We postulated that this cervicodeltopectoral (CDP) flap will allow for single-stage reconstruction of large defects of the anterolateral face and neck. METHODS: As is the case with the deltopectoral flap, the CDP flap is based on the perforating branches of the internal mammary artery. However, the superior and posterior limbs of the CDP flap are not limited by the clavicle and the deltoid muscle. Instead, they extend in a subcutaneous tissue plane to the margins of the neck or facial defect and transfer the entire intervening skin bridge with the deltopectoral flap. RESULTS: Eighteen patients underwent closure of complex cutaneous defects of the face and neck with the CDP flap. We found no evidence of flap loss in any of these patients. Twelve patients had received preoperative radiation therapy encompassing the cervical extension of the CDP flap. No evidence of adverse healing was noted in this subset of patients. CONCLUSIONS: The CDP flap may represent an alternative in the surgical treatment of various cutaneous defects of the face and neck. It allows for single-stage, reliable reconstruction of these defects. The transfer of intervening cervical skin in conjunction with the deltopectoral flap provides for a more aesthetically pleasing reconstruction, as skin immediately adjacent to the defect is more closely related to the excised skin in terms of color and texture.