World’s largest PMMC Flap harvested by the Team of Doctors at KRIMS Hospitals, Nagpur for the Facial Reconstruction Su

1. Press Note “World’s largest PMMC Flap harvested by the Team of Doctors at KRIMS Hospitals, Nagpur for the Facial Reconstruction Surgery” A 23 year old male patient Mr. Sachin Patil (name changed), resident of Kuhi – Nagpur was admitted to KRIMS Superspeciality Hospital Ramdaspeth Nagpur, on 23rd November 2017 with a large wound on right side of the face. The swelling was busted and exposed to the external environment with large number of Maggots (Insects) in the wound. The wound was so extensive that the Maggots ate the right cheek completely. This primarily seemed to be the case of a very Advanced Carcinoma of Buccal Mucosa involving Maxilla and Mandible exposing the teeth and the jaw bone. Looking towards the severity of the condition, Maggots were removed immediately with proper surgical debridement and medical treatment with proper isolation of the patient in ICU. After all the investigations were done and the biopsy reports were available, the condition was diagnosed as Advanced Squamous Cell Carcinoma (Cancer). The treatment plan was decided and the surgery was planned. Complete wide excision of the lesion was done along with partial Maxillectomy, Hemi-mandibulectomy and Radical neck dissection. A 13×9 cm2 PMMC (Pectoralis Major Myocutanius) Flap from right side of the chest was harvested for the reconstruction of the defect. This was the largest PMMC Harvested Flap recorded till now in the World, as per the scientific article available, since Microvascular is a good choice but financial condition was not supporting any free flap as free Fibula and Lattisimusdorsi with Microvascular Anastomosis. Sachin was then shifted to ICU for 4 days. After rapid and progressive recovery, Sachin was shifted to the ward for 15 days. Now Sachin has recovered completely with best flap outcome which is the largest recorded PMMC Flap used in largest composite surgical defect reconstruction for Head Neck region of economically compromised patient. This supramajor surgery was carried out by Dr. Chandrashekhar Bande, Consultant Oral Cancer & Facial Plastic Reconstructive Surgeon & assisted by Dr. Monica Mahajan, Consultant Oral & Maxillofacial Surgeon, Dr. Krishakurawar, Dr. Ashish Maheshkar, Anaesthetist Dr. Rasika Timane & Chest physician Dr. Sameer Arbat (It was a difficult intubation so fiber-optic intubation was done by Dr. Sameer Arbat) and Senior Physician & Intensivist Dr. Jayesh Timane & Dr. Shyam Meshram supported by the best nursing care to patient with the experienced paramedical team.