Pacman flap for oncologic reconstruction of soft-tissue defects after tumor resection A retrospective case series

Introduction: The Pacman flap is a novel modality for repairing round soft-tissue defects after tumor resection. This modality provides a robust blood supply without microsurgical tissue rearrangement. This article reviews the authors' experience with Pacman flap for reconstruction of round soft-tissue defects. The safety and effectiveness of the Pacman flap are investigated. Methods: Here, we describe a method for oncologic reconstruction of round soft-tissue defects with a Pacman flap after tumor resection. Fourteen consecutive patients (6 males and 8 females, median age of 60 years, range, 18-87 years) who received Pacman flaps for oncologic reconstruction during the period from April 2015 to April 2017 were included in the present study. Results: In total, 15Pacman flaps (including 1 bilateral Pacman flap) were created to provide coverage after resection of a tumor from the face (n=11), chest (n=1), or extremities (n=2). One patient had twice previously undergone tumor resection. Median defect size was 25.5 x 25 mm (range, 9 x 9-100 x 90 mm). Median flap size was 35 x 27 mm (range, 12 x 10-120 x 110 mm). Median duration of follow-up was 10 months (range, 6-22 months). No local or distal tumor was observed during the follow-up period. All flaps survived without partial or complete necrosis, infection, or other complications. All patients were satisfied with their aesthetic outcomes. A hematoma formed in 1 patient and was successfully treated with debridement. Conclusions: The Pacman flap enables the surgeon to achieve tension-free round defect closure after tumor resection, with good functional and aesthetic outcomes. This modality is a reliable and effective reconstructive surgical technique for oncologic reconstruction of round soft-tissue defects.