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A D V E R T I S E M E N T
A D V E R T I S E M E N T
A 47-year-old Caucasian male presented with PMH of SCC of the right shoulder with history of radiation after initial excision. Initial lesion pathology showed basosquamous cell carcinoma measuring 10.9 x 3.2 x 2.2 cm.
Pt developed abscess to right shoulder after excision of the lesion which required incision and drainage.
A D V E R T I S E M E N T
The wound was left to heal by secondary intention with placement of Integra. By the end of the healing process the wound measured 80 x 35 x 4 mm. The wound had an area of radio necrosis at the base and exposure of the distal clavicle. Reconstructive surgery with a myocutaneous pectoral flap was planned. The patient symptoms included decreased ROM, pain and serous discharge.
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A D V E R T I S E M E N T
The pectoralis major has two heads of attachment: the sternocostal head with attachment of ribs 1-7 to lateral lip of biceptal groove on the humerus, and the clavicular head with attachment of the clavicle to acromium. The main functions of the pectoralis major muscle are internal rotation and adduction of the arm. The pectoralis major is supplied by the pectoral branch of the throacoacromial artery (a branch of the subclavian).
Motor innervation of the pectoralis major is supplied by the medial and lateral pectoral nerves. Often these nerves are cut during flap harvest to allow larger range of motion to the flap. This denervation also leads to advantageous atrophy of the muscle in its new location.
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This page was last modified on 5/6/2016.
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