|1. Pectoralis Major |
- Pectoral branch of the acrominothoracic artery arising from the first part of the axillary artery.
- External segment (50%) may be supplied by lateral thoracic vessels of 2nd part of axillary artery.
- Sternocostal segment
- Perforating branch of internal mammary.
|1. Large |
2. Rich Vascular supply
3. Large arc of rotation ~zygomahc arch
4. Versatile : Skin only / muscle paddle with skin / muscle
5. Harvested in supine posterior
6. Donor site Primary closure.
|1. Large and Bulky
2. Relatively Immobile
3. Violates female breast.
|Latissimus Dorsi Flab|
- 1st myocutaneous flab.
-Thoracodorsal vessels -> Subscapular -> Acteytol D
- Venae Commitantes -> axillary vein
-thoracodorsal nerve ( Posterior cord of brachial plesous)
|1. Large Amount (10x8 cm)|
2. Pedicled/ Free Tissue Transfer
3. Cosmetic advantage in female
4. Versatile tubed
5.when pedicled it can reach upto upper face and scalp.
|1. Very Bulky
2. Donor site dehiscense ocassionally
3. Reduction in upper limb power.
4.May require moving the patient to harvest.
-2 branches of occipital artery (Upper Half )
- Superior thyroid artery branch in lower half.
- Rarely used.
|1. Can be used as componk|
skin = muscle flab / muscle = bone flab
2. Split along its length and rotate anterior to cover vessels in compromised vein
|1. Poorly vascularized and not reliable
2. Areas of oncological significance
3. Superior reconstructure ophon available.
- Vascular supply complex and varies with design
Occopital artery and venae comitantes
|1. Used for defect of the temporal bone, Lateral face or upper neck|
2. Lifeboat / Salvage when other flap fails.
Upper Part -> Submental branch of facial artery
Lower Part -> Transverse cervical artery branch
|1. Unreliable blood supply
2. Avoid as source of reconstruction of oral cavity
3. May remove blood supply of overlying skin.
4. Area of oncological significance.