The Free Scapular Flap

Hahn, Soo Bong; Kim, Yeoh Seob

Abstract

The simple cutaneous flap and myocutaneous flap are presently being employed in skin defects since Daniel and Taylor first tried the free flap in 1973. But the simple cutaneous flap which is being employed at present has problem in the flap size, the variation and complexity of the anatomical structure and postoperative complication of the donor site. On the other hand, the myocutaneous flap has partially solved the problem of a simple cutaneous flap, but the myocutaneous flap remains inadequate when thin flap reconstruction only is required. The scapular flap was first suggested by Saijo in 1978 and Santos described the anatomical aspects of the scapular flap in 1980. Since Gilbert first clinically utilized the scapular flap, it was seen to be much more suitable for relatively thin cutaneous flaps, The authors present 10 cases of free scapular flap performed at the Department of Orthopedic Surgery of Severance Hospital during the period of one year and 2 months from April, 1983 until June, 1984. The results of the study are as follows: 1. The scapular flap was of medium size in 9 cases and large in one case. 2. The pedicles of the scapular flaps were constant in length and diameter. 3. The flap was uniform and relatively thin in thickness. 4. The reconstruction of a large soft tissue defect was possible with a combination of scapular flap and latissimus dorsi myocutaneous flap done in one stage. 5. The donor site of a scapular flap can be primarily closed. 6. The free scapular flap is an excellent choice when intermediate-sized or large-sized uninnervated flap coverage is necessary for soft tissue damage.