Reconstruction of various sized soft tissue or compound tissue defect using free serratus anterior muscle or composite flap

Chung, Ho Yun; Lee, Jung Hyung; Cho, Byung Chae; Baik, Bong Soo

Abstract

A wide variety of free muscle or composite flaps have been used clinically for the reconstruction of soft tissue or compound tissue defects since introduction of the microsurgical technique but there were still difficulties in their application due to donor site morbidity and flap bulkiness. Free serratus anterior muscle flap and free composite flap, including serratus anterior muscle have been applied to 17 patients with small or medium sized tissue defects or large sized compound tissue defects from June 1995 to July 1997. There were 11 male cases and 6 female. Average age was 27 years. Defect sites were the anterior tibial area in 6 cases, the dorsum of foot in 6, the medial malleolar area in 1, the heel area in 1, the foot in 2, and the thumb and 1st web space in 1. There were 12 free muscle flaps, 2 free serratus anterior and rib composite flaps, 2 free serratus anterior and latissimus dorsi combined muscle flap and 1 free serratus anterior and latissimus doris and rib composite flap. The average follow up period was 14 month. The survival rate was 100% in 16 cases, 80% in 1 case. There was no remarkable donor site morbidity and operative results were satisfactory in all cases. The advantages of this flap are consistent and reliable flap with minimal donor site morbidity, long constant large caliber pedicle, taking a thin flap, excellent malleability allowed a broad of range of inserting technique, and additional possibility of a composite flap.