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The Scapular Osteofasciocutaneous Flap: a 12-year Experience

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Date 2001 Aug 4
PMID 11448364
Citations 25
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Abstract

Objective: To elucidate the factors that play a role in the decision-making process to use the scapular donor site, we have reviewed our 15-year experience with 57 clinical cases, to our knowledge the largest case series to date.

Design: Retrospective, single-surgeon medical record review.

Patients And Methods: Retrospective review of 57 consecutive cases (53 patients) involving mandibular and maxillary reconstruction using bone-containing scapular free flaps over a 15-year period. Composite flap composition as well as donor and recipient site complications were recorded.

Results: Forty-one reconstructions were performed for mandibular defects, 11 were performed for maxillary defects, and 5 for combined defects involving the mandible and maxilla. Seven flaps were composed of 2 separate bone flaps using the angular branch and the circumflex scapular artery. A total of 6 flaps were failures in 5 patients, giving an overall success rate of 89%.

Conclusions: The subscapular system of flaps is a versatile donor site that offers distinct advantages in the older patient population as well as in patients with a preexisting gait disturbance. It is particularly advantageous in patients requiring a large surface area of soft tissue to restore their defect.

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