PMC3385384_01
Preoperative photograph showing ulcerated carcinoma cheek with ulcerating neck node
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F1
We are describing the procedure in a 43-year-old female patient with squamous cell carcinoma of right side buccal mucosa with skin involvement and ulcerating neck node [Figure 1].
Intraoperative photograph showing planning of the flaps - medially based platysmal myocutaneous flap (a), laterally based platysmal myocutaneous flap (B), deltopectoral flap (c) and pectoralis major myocutaneous flap (d)
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F2
DP flaps were planned [Figures 2 and 3]. Deltopectoral flap was elevated followed by pectoralis myocutaneous flap.
Showing planning of flaps (a) medially based platysmal myocutaneous flap (b) laterally based platysmal myocutaneous flap (c) deltopectoral flap and pectoralis major (d) myocutaneous flap
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F3
DP flaps were planned [Figures 2 and 3]. Deltopectoral flap was elevated followed by pectoralis myocutaneous flap.
Intraoperative photograph showing the inset of the flaps into their respective positions with skin-grafted chest wall (flap D is used for lining and hence not seen in the picture)
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F4
The residual raw areas were skin grafted [Figures  4 and 5].
Eighth day postoperative photograph of the same patient, showing well settled medially based platysmal myocutaneous flap (a), laterally based platysmal myocutaneous flap (b) and deltopectoral flap (c)
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F5
The residual raw areas were skin grafted [Figures  4 and 5].