Fascial Release of the Pectoralis Major: A Technique Used in Pectoralis Major Muscle Closure of the Mediastinum in Cases of Mediastinitis

Abstract

The authors present a new technique that can be used to gain additional width from the right pectoralis major muscle in cases of mediastinal reconstruction using the pectoralis major muscle flap. With the added 26 percent of width obtained from the right pectoralis major muscle with fascia release, the authors contend that a sturdier and tension-free closure of the mediastinal dead space can be obtained, further expanding the indications for use of the pectoralis major muscle flap as the sole closure modality in even the most complicated cases of mediastinitis.

Exercise induced compartment syndrome of the pectoralis major/deltoid in a professional tree climber

“…The fascia over the pectoralis major 12 and anterior upper arm was released ( Figure 2). Epimysiotomy 8 was also performed over the deltoid compartments.…”

Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection

“…In contrast to omental flaps, the pectoral muscle flap technique is not standardized. Extension of mobilization, fascial release, splitting of the muscle fibers and preservation of the perforators, humeral insertion and thoracoacromial vessels constitute important contentious technical points [5,13,14]. Our approach is conservative as we aim to preserve the site of humeral insertion and only use the pectoralis major as an advancement flap, while maintaining the intercostal perforators [5], aiming to maximize muscle perfusion and minimize functional impairment, which can be significant [1].…”

Simple and reliable way in sternum wound coverage—Tripedicle pectoralis major musculocutaneous flap

“…Skeletalization of the main pedicle and release of the PM muscle fascia can effectively stretch the muscle length by 5.8 cm. 29 Perspective, we prefer to use a pedicle flap that fulfills the following criterias: reliable flap survival, short surgical time, and one-stage procedure. This is especially true if the patient is hemodymanically unstable.…”