Case report
Managing an Uncommon Complication of Pectoralis Major Myocutaneous Flap Surgery: Chest Wall Sinus with Rib Osteomyelitis
PD08-PD10
Correspondence
Dr. Devendra Yadav,
Junior Resident, Department of General Surgery, Dr. D. Y. Patil Hospital and Research Center, Pimpri-Chinchwad-411018, Maharashtra, India.
E-mail: devendrayadav11@hotmail.com
Chest wall sinus with underlying rib osteomyelitis is a rare complication following Pectoralis Major Myocutaneous (PMMC) flap reconstruction in head and neck cancer surgeries. Effective identification and surgical management are essential to prevent recurrence. A 58-year-old male presented with a history of squamous cell carcinoma of the left lower alveolus, initially managed with composite resection and PMMC flap reconstruction. One month postoperatively, the patient presented with a discharging sinus over the anterior chest wall. High-Resolution Computed Tomography (HRCT) revealed rib osteomyelitis. Surgical excision of the sinus tract was performed using methylene blue dye to delineate its extent, followed by rhomboid flap reconstruction. The patient had an uneventful recovery, with healthy flap healing and no recurrence by postoperative day 10. After PMMC flap reconstruction, the anterior chest wall sinus with rib osteomyelitis is an uncommon but significant postoperative complication. Prompt identification, total sinus excision, and rhomboid flap reconstruction guarantee efficient treatment and the best possible outcome.