Usefullness of Chimeric Flaps Based on the Subscapular Vascular System.

Kim, Hyon Surk; Lim, Hyung Woo; Park, Seung Ha; Lee, Byung Il

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(5):597-604.
Published online September 1, 2009.

Usefullness of Chimeric Flaps Based on the Subscapular Vascular System.

Hyon Surk Kim, Hyung Woo Lim, Seung Ha Park, Byung Il Lee

Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea. guro@korea.ac.kr

Abstract

PURPOSE
Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. METHODS: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall.
RESULTS
Defect sizes ranged from 6x8cm to 20x22 cm. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. In all cases reconstruction was done successfully without additional operative procedures or flap necrosis.
CONCLUSION
Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one-stage reconstruction tailored to the characteristics of the defect area.

Keywords: Chimeric flap; Subscapular vascular system

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