The Origins of Deltopectoral Flaps and the Pectoralis Major Myocutaneous Flap.

The aim of this paper was to review the origins and history of deltopectoral flaps and the pectoralis major myocutaneous flap. The first published paper on the deltopectoral flap was written by Aymard in 1917. He described raising a medially based fasciocutaneous flap from the shoulder skin, which was then tubed and used for staged nasal reconstruction. Conley introduced the laterally based deltopectoral flap, which was supplied by the lateral thoracic and thoracocranial branches. Bakamjian used a medially based deltopectoral flap for pharyngoesophageal reconstruction; this was an axial flap based medially on the intercostal perforating vessels of the internal mammary artery. Krizek reviewed the literature and stated that Aymard flap was the keystone to the conception and execution of Bakamjian flap. Hueston was the first to combine a skin flap and pectoralis major muscle for repair of the large defects of the chest wall. The pectoralis major myocutaneous flaps described by Ariyan and Baek are a hybrid of Conley's laterally based deltopectoral flap and Hueston's inclusion of the pectoralis major muscle in the skin flap. When the authors develop what appears to be a new surgical technique, the authors are prone to be excited. However, at such a moment the authors must perform a literature review. In most patients, the authors will realize that the previous authors have already developed a given concept. The authors must not commit plagiarism due to their ignorance or laziness in conducting a literature review. (C) 2016 by Mutaz B. Habal, MD.

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