Practical Tips for Pectoralis Major Myocutaneous Flap

The pectoralis major myocutaneous flap was first described for head and neck reconstruction by Ariyan in 1979. Surgical innovations allowing for the harvest of composite tissue, including bone and multiple skin paddles, led to the widespread adoption of this flap in the late twentieth century. While free flaps have since supplanted regional flaps as the primary reconstructive option for head and neck defects, the pectoralis major flap is still a viable option as a salvage flap or as a primary reconstructive option for patients who are not candidates for free flaps. Benefits include excellent flap survival rates, ease of harvest, relatively short operative time, and abundant soft tissue allowing for various reconstructive options. The purpose of this chapter is to review pearls and pitfalls in harvesting pectoralis major myocutaneous flap.