Primary closure of the deltopectoral flap-donor site without skin grafting

Abstract

Background and objective: Deltopectoral flap is a two staged flap requiring skin graft of the donor site. This study was conducted to evaluate the possibility of primary closure of the deltopectoral flap-donor site without skin grafting. Methods: The operations were conducted at Rizgari Teaching Hospital in the center of Erbil City, Kurdistan Region of Iraq. From January 2009 to December 2012, 14 deltopectoral flaps for reconstruction of oral/facial cancer ablative defects were done. Data on the age, gender, tumor site, and postoperative complications related to primarily closed deltopectoral flap-donor site (fistula, dehiscence, or hematoma leading to impairment of wound healing) and postoperative hospital stay were recorded. Results: Of the 14 head-and-neck tumours, 10 were squamous cell carcinomas and four were ameloblastomas. Eleven of the patients were males and only three were females. The mean age (±SD) of the patients was 59±13 years. There was no evidence of partial or complete loss of the flap in any of the patients studied. There was no case of breakdown of the primarily closed donor site. The only registered complication was slight localized dehiscence at the most proximal and distal part of the primarily sutured flap donor site in one patient. Conclusion: Primary closure of deltopectoral flap donor site is possible with minimal complication that overcomes the problem of skin grafting. Minimal wound breakdown in younger patients had been noted and left to heal by secondary intention.