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Research article
Jude Opoku-Agyeman
Philadelphia College of Osteopathic Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2796-0186
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives
The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques.
Methods
EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures.
Results
The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b).
Conclusion
There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.
Keywords
Sternoclavicular defect, sternoclavicular joint, pectoralis muscle flap
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
No community comments so far
Submission checks complete
On 07 Nov, 2019
Editorial decision: Accept
On 05 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 03 Sep, 2019
Editor assigned
On 25 Aug, 2019
Submission checks complete
On 24 Aug, 2019
Editor invited
On 24 Aug, 2019
Version 1
Posted 06 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 19 Aug, 2019
Review #2 received
Received 29 Jul, 2019
Reviewer #2 agreed
On 15 Jul, 2019
Review #1 received
Received 06 Jul, 2019
Reviewers invited
Invitations sent on 05 Jul, 2019
Reviewer #1 agreed
On 05 Jul, 2019
Editor assigned
On 03 Jul, 2019
Submission checks complete
On 02 Jul, 2019
Editor invited
On 02 Jul, 2019
Metrics
Comments: 0
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Jude Opoku-Agyeman
Philadelphia College of Osteopathic Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2796-0186
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Surgery.
No community comments so far
Submission checks complete
On 07 Nov, 2019
Editorial decision: Accept
On 05 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 03 Sep, 2019
Editor assigned
On 25 Aug, 2019
Submission checks complete
On 24 Aug, 2019
Editor invited
On 24 Aug, 2019
Version 1
Posted 06 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 19 Aug, 2019
Review #2 received
Received 29 Jul, 2019
Reviewer #2 agreed
On 15 Jul, 2019
Review #1 received
Received 06 Jul, 2019
Reviewers invited
Invitations sent on 05 Jul, 2019
Reviewer #1 agreed
On 05 Jul, 2019
Editor assigned
On 03 Jul, 2019
Submission checks complete
On 02 Jul, 2019
Editor invited
On 02 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Surgery.
Objectives
The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques.
Methods
EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures.
Results
The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b).
Conclusion
There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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