Functional donor-site morbidity following reconstruction with pectoralis major flaps: A systematic review.

Autor:	Falade IO; School of Medicine, University of California San Francisco, San Francisco, CA, USA., Murphy AI; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA., Switalla KM; Medical School, University of Minnesota - Twin Cities, Minneapolis, MN, USA., Yin RR; School of Medicine, University of California San Francisco, San Francisco, CA, USA., Rose JA; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	JPRAS open [JPRAS Open] 2024 Jan 23; Vol. 39, pp. 278-290. Date of Electronic Publication: 2024 Jan 23 (Print Publication: 2024).
DOI:	10.1016/j.jpra.2024.01.007
Abstrakt:	Background: Pectoralis major muscle/myocutaneous flaps (PMMFs) are commonly used in reconstructive surgery, but may result in shoulder disability on the donor side. A systematic review evaluating this morbidity could be beneficial for guiding patients and providers considering this procedure. Methods: In October 2022, a systematic review of studies evaluating quantitative/qualitative measures of functional morbidity after PMMF was conducted. The results were categorized into PMMF's effect on range of motion (ROM), strength, and ability to complete shoulder-related activities/quality of life. Results: Eleven studies were included for analysis, which analyzed standard PMMF and two PMMF variants that spared portions of the muscle. Three of five studies demonstrated reduced shoulder ROM for standard PMMF versus controls lasting at least 4 months after head and neck reconstruction. Two of five studies, including two prospective studies demonstrated reduced shoulder strength for standard PMMF versus controls lasting at least 3 months after surgery. Five of nine studies found significant impairment in the ability to conduct shoulder-related activities, including work, up to one year postoperatively for standard PMMF versus controls. Muscle-sparing PMMF variants exhibited more promising outcomes in some categories. Conclusion: Standard PMMF results in prolonged reductions in shoulder ROM and strength, which may impair patients in shoulder-related activities. Other reconstructive options should be considered in patients who frequently participate in such activities. For patients requiring PMMF, muscle-sparing PMMF variants should be considered as alternatives to the standard PMMF. Competing Interests: None declared. (© 2024 The Author(s).)
Databáze:	MEDLINE
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