Patient Education: Pectoralis Major Flap

‍

Introduction to the Procedure

• Purpose: Explain that the pectoralis major rotational flap procedure involves using a portion of the pectoralis major muscle, along with overlying skin and tissue, from the chest to reconstruct areas in the neck. This might be necessary following surgical removal of cancer, trauma, or infection that has resulted in significant tissue loss or defect.
• Benefits: Highlight the benefits, such as reliable blood supply to the flap ensuring good healing, relatively straightforward surgery compared to free flaps, and using the patient's own tissue which reduces the risk of rejection.

Description of the Surgical Process

• Preoperative Preparation: Discuss any preoperative evaluations or procedures that may be needed, such as imaging studies, blood tests, and consultations with various healthcare providers.
• The Surgery: Describe the steps of the surgery:
  • Anesthesia: The procedure is performed under general anesthesia.
  • Harvesting the Flap: An incision is made along the chest to access and mobilize the pectoralis major muscle and overlying skin.
  • Rotation to the Neck: The flap is then rotated into the neck area to cover the defect.
  • Reattachment and Closure: The flap is secured in place with sutures, and both the donor and recipient sites are closed. Drains might be placed to prevent fluid accumulation.
• Duration: The surgery usually takes several hours, depending on the complexity of the neck defect and the patient’s overall health.

Risks and Potential Complications

• General Surgical Risks: Such as infection, bleeding, or reactions to anesthesia.
• Specific Risks: Include partial or total flap loss, reduced sensation at the donor or recipient site, and aesthetic concerns such as scarring and contour differences of the chest.
• Need for Additional Procedures: Sometimes further surgeries are needed for optimal functional and cosmetic results.

Postoperative Care and Recovery

• Immediate Postoperative Care: The patient will typically stay in the hospital for a few days to monitor the healing process and manage pain.
• Home Care: Instructions on wound care, signs of infection, managing pain, and when to call the healthcare provider.
• Activity Restrictions: Limitations on physical activities, especially arm movements that might stress the surgical site, will be discussed. Recommendations will include avoiding lifting, straining, or vigorous exercise for a specified period.
• Follow-Up Appointments: Stress the importance of attending all scheduled follow-up appointments to ensure proper healing and to address any complications early.

Long-Term Outcomes

• Healing Process: Complete healing and final results may take several weeks to months. The patient should be prepared for a gradual improvement.
• Physical Therapy: Depending on the extent of the surgery, physical therapy may be recommended to regain full range of motion and strength in the shoulder and chest area.

Support and Resources

• Psychological Impact: Acknowledge the emotional and psychological aspects of undergoing significant reconstructive surgery and provide information on support resources if needed.
• Educational Materials: Offer brochures or links to reliable online resources for additional information about the procedure and recovery.

‍