Use of the extended pectoralis major myocutaneous flap as a wrap-around for mediastinal tracheal repair

Summary: Persistent tracheoesophageal fistulas requiring flap repair of the trachea in the mediastinum are uncommon. A 44-year-old man developed a 5 cm x 2 cm persistent posterior tracheal defect after failed tracheo-esophageal fistula repair. The defect was patch repaired using the de-epithelialize...

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Autores principales: Grace Hui-Min Tan, (MRCS), Boon-Hean Ong, (FRCSEdTh), Yee-Onn Kok, (MRCS), Bien-Keem Tan, (FRCS)
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
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Acceso en línea:https://doaj.org/article/653a5c8e38ce44aa993f1245c5a8ca15
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Sumario:Summary: Persistent tracheoesophageal fistulas requiring flap repair of the trachea in the mediastinum are uncommon. A 44-year-old man developed a 5 cm x 2 cm persistent posterior tracheal defect after failed tracheo-esophageal fistula repair. The defect was patch repaired using the de-epithelialized skin paddle of an extended pectoralis major flap tunneled into the mediastinum. The use of cross-field ventilation, second rib removal and an anterior tracheostomy slit were crucial for posterior tracheal repair. No major complication occurred. The patch repair with the de-epithelialized skin paddle of pectoralis major flap mucosalized in 2 weeks and the patient was discharged one month postoperatively. The extended skin paddle of the pectoralis major flap was a useful method for tracheal wrap-around reconstruction.