{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T04:52:01Z","timestamp":1768366321228,"version":"3.49.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":37,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Datta Meghe Institute of Higher Education and Research"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Orocutaneous fistula is a challenging postoperative complication often encountered in head and neck reconstruction, typically resulting from surgical site dehiscence, infection, or compromised flap vascularity. While the pectoralis major myocutaneous flap has historically been a reliable option for reconstruction, its failure\u2014though uncommon\u2014can lead to persistent fistula formation. This case highlights the effective use of combined local tissue rearrangement and free anterolateral thigh flap for successful secondary reconstruction following pectoralis major myocutaneous flap failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 31-year-old Indian male patient, previously treated with composite resection and pectoralis major myocutaneous flap reconstruction for carcinoma of the buccal mucosa, presented with orocutaneous fistula due to pectoralis major myocutaneous flap dehiscence and partial necrosis. Conservative wound care failed to achieve closure. The patient underwent secondary reconstruction using local tissue rearrangement and a free anterolateral thigh flap. Postoperative recovery was uneventful, with successful closure of the fistula and restoration of orofacial continuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores the importance of timely secondary intervention using free tissue transfer and local flap adjustment in managing orocutaneous fistula following pectoralis major myocutaneous failure. The combined approach provided durable closure and functional restoration, offering a viable option in complex salvage scenarios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13256-025-05658-5","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:24:55Z","timestamp":1765005895000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterolateral thigh flap to the rescue: anterolateral thigh free flap for secondary reconstruction of facial defect post oncosurgery\u2014a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1052-0791","authenticated-orcid":false,"given":"Divya Suvarna","family":"Dixit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firoz","family":"Borle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Bhola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0219-7049","authenticated-orcid":false,"given":"Bhushan","family":"Mundada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"issue":"3","key":"5658_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1055\/s-2008-1081398","volume":"22","author":"D Kademani","year":"2008","unstructured":"Kademani D, Mardini S, Moran SL. Reconstruction of head and neck defects: a systematic approach to treatment. Semin Plast Surg. 2008;22(3):141\u201355. https:\/\/doi.org\/10.1055\/s-2008-1081398.","journal-title":"Semin Plast Surg"},{"issue":"1","key":"5658_CR2","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1007\/s12663-019-01228-7","volume":"19","author":"V Anehosur","year":"2020","unstructured":"Anehosur V, Dikhit PS, Nagraj N, Jayade B, Kumar N. PMMC flap revisited and its clinical outcome in 150 patients. J Maxillofac Oral Surg. 2020;19(1):26\u201331. https:\/\/doi.org\/10.1007\/s12663-019-01228-7.","journal-title":"J Maxillofac Oral Surg"},{"issue":"7","key":"5658_CR3","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1097\/01.ASW.0000661800.39497.94","volume":"33","author":"X Lou","year":"2020","unstructured":"Lou X, Xue C, Molnar JA, Bi H. A method to reproduce symmetry in midfacial reconstruction: a report of 19 cases. 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