The authors present the double-paddled pectoralis major myocutaneous flap as a successful alternative for the reconstruction of complex orocervical defects following failure of prior microvascularized free flaps or free flap harvest is not feasible. This method was used for the reconstruction of post-ablative defect in a 36-year-old male with a T4 squamous cell carcinoma of the base of tongue with laryngeal involvement. The distal paddle was adapted to reconstruct a defect of the floor of the mouth and further sutured in two layers (muscle-basal mandible and skin paddle-oral mucosa) while the proximal skin paddle was used to close the cervical skin and the peri-tracheostomy defect.

Aim: The aim was to study the effectiveness of the reverse latissimus dorsi muscle flap in reconstruction of complex defects of the back. Methods: This is a retrospective study of patients who underwent reverse latissimus dorsi flap for reconstruction of the back, in a tertiary care hospital. The patient demographics, etiology, surgery indications and complications were studied. Results: The study had five patients between 2012 and 2016 who underwent reverse latissimus dorsi flap for reconstruction. The flaps survived in all the patients. Two patients had complications, unrelated to the latissimus dorsi muscle flap. Conclusion: The vascularity of the flap is reliable can be used to obliterate the dead space, can be used to control the infection, in complex cases of the back.

Aim: This study aimed to investigate the efficacy of the myocutaneous flap of the rectus abdominis in the surgical treatment of a large defect on the female chest following keloid excision.Methods: According to the location and size of the keloid on the chest, a myocutaneous flap based on the left or right rectus abdominis muscle was designed and transferred for repair of a chest defect following keloid resection. Radiotherapy was performed in the surgical area on the first and seventh postoperative days.Results: From January 2015 to March 2016, rectus abdominis myocutaneous flap coverage and early radiotherapy were used to treat 7 cases of keloids on the female chest. A postoperative follow-up of 10-14 months (average 12 months) was conducted. All the flaps survived well without evidence of keloid recurrence, and all patients achieved an improved chest shape.Conclusion:The rectus abdominis myocutaneous flap is a viablemethod for wound closure following resection of large keloids on the female chest.