Novel Technique to Increase the PMMC Flap Pedicle Length by Coplanar Rotation Along the Pedicle Axis

  • Rajeev SharanEmail author
  • Anoop Attakkil
  • Kapila Manikantan
  • Pattatheyil Arun
Technical Note


Pectoralis major myocutaneous flap (PMMC) continues to be a prime tool in the armamentarium for the reconstruction of head and neck malignancies even though free flaps have proved their versatility in functional and cosmetic outcomes. It still holds significance in both primary reconstruction and salvage procedures in head and neck malignancies. Inadequate infrastructure and resources make PMMC a preferred choice in many high-volume centres of developing countries. However, the length of the PMMC flap becomes a limiting factor for the distance that flap can be transferred when extensive reconstructions are being planned (Kudva et al. in J Maxillofac Oral Surg 14:481–483, 2015). We propose a modification in the conventional technique that maximises the length of the pedicle in orofacial reconstruction. Our technique allows the rotation of skin paddle along the longitudinal axis of the pedicle at the distal end along the same plane. This technique provides an easily reproducible and reliable technique that enables the surgeon to enhance the reach of the skin paddle and flexibility considerably.


Head and neck cancer PMMC flap Pectoralis myocutaneous flap PMMC flap pedicle length Oral cancer reconstruction Oral cancer 


Compliance with Ethical Standards

Conflict of interest

The authors have declared that they have no conflict of interest.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Ethical approval from Institutional Review Board approval was sought for and has been advised that the same is not required as it is a retrospective article.

Informed Consent

Informed consent was obtained from all individual participants for using the photographs and data included in the study.


  1. 1.
    Kudva A, Patil R, Patil BR (2015) A Technique to maximise length of pectoralis major muscle myocutaneous flap pedicle in orofacial reconstruction. J Maxillofac Oral Surg 14(2):481–483CrossRefGoogle Scholar
  2. 2.
    Liu M, Liu W, Yang X, Guo H, Peng H (2017) Pectoralis major myocutaneous flap for head and neck defects in the era of free flaps: harvesting technique and indications. Sci Rep 7(December 2016):1–9Google Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of Head and Neck Surgical OncologyTata Medical CenterKolkataIndia

Personalised recommendations