MANAGEMENT OF CAROTID-ARTERY EXPOSURE WITH PECTORALIS MAJOR MYOFASCIAL FLAP TRANSFER AND SPLIT-THICKNESS SKIN COVERAGE

The risk for post-operative exposure of the carotid artery due to skin flap necrosis after major head and neck surgery is increased after pr evious radiation and in severely malnourished patients. Eight patients are described who presented with an (imminent) carotid exposure one t o eight weeks after surgery. Pectoralis major myofascial flap transfer with split thickness skin graft coverage was used for protection of t he carotid artery. All cases were managed successfully and healed prim arily in two to four weeks with acceptable cosmesis. We advocate immed iate treatment in the event of an exposed carotid (or imminent exposur e) by a pectoralis major myofascial flap with split-thickness skin gra fting.