Lateral extension of the free scapular flap

Arnezˇ, Z.M.; Scamp, Terrence; Planinsˇek, Franci; Aheˇan, Urosˇ

doi:10.1016/0007-1226(94)90010-8

Cited by 14 publications

(3 citation statements)

References 7 publications

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“…The mega‐flap helped accomplish these goals by providing an abundance of soft tissue components that could be safely moved in 3 dimensions relative to the vascularized segment of bone. Several other case series and reports have also demonstrated favorable outcomes and reliability using compound flaps harvested from the subscapular system, albeit in non–vessel‐depleted necks …”

Section: Discussionmentioning

confidence: 92%

Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

et al. 2012

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Section: Discussionmentioning

confidence: 92%

Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

et al. 2012

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“…33 La extensión del colgajo puede aumentarse medialmente incluyendo el colgajo escapular basado en la rama horizontal de la arteria circunfleja escapular, y se han registrado dimensiones de hasta 45 x 12 cm realizadas en forma segura. 20,27,34,35 En cinco casos de nuestra serie, se utilizaron colgajos de 30 cm o más sin ninguna complicación. Izadi y cols.…”

Section: Discussionunclassified

Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

Vanoli

Murillo

Centeno

et al. 2018

Rev. Asoc. Arg. Ort. y Traumatol

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ResumenIntroducción: El objetivo de este artículo es comunicar los resultados obtenidos con el uso del colgajo paraescapular para cubrir defectos severos postraumáticos de tejidos blandos en las extremidades. Materiales y Métodos: Estudio retrospectivo, descriptivo, de una serie de 20 pacientes a los que se les realizó un colgajo libre paraescapular para cubrir lesiones masivas combinadas postraumáticas de tejidos blandos en las extremidades, entre 2006 y 2017. La edad de los pacientes promedió 30 años (18 hombres, 2 mujeres). La localización de las lesiones fue: 10 en antebrazo y muñeca, una en la región inguinal, siete en la pierna y dos en tobillo/pie. Resultados: El seguimiento promedio fue de 3.6 años. Se logró la cobertura exitosa en 17 casos. El tamaño de los colgajos promedió 24,8 x 10,7 cm. Seis casos presentaron lesiones vasculonerviosas que necesitaron injerto, seis se asociaron a pérdidas óseas, 11 requirieron injerto de piel y cuatro, reconstrucciones tendinosas. En todos los pacientes, el área donante cerró en forma primaria y sin secuelas funcionales. Dicho colgajo se combinó con el escapular en tres casos y con colgajo de dorsal ancho en tres casos. Dos colgajos fallaron y debió amputarse la extremidad lesionada; un paciente falleció por embolia masiva al séptimo día de la cirugía. Conclusiones: El colgajo paraescapular permitió salvar y reconstruir satisfactoriamente defectos masivos extensos en 17 de 20 extremidades, sin morbilidad para la zona donante del colgajo, pero su uso no está exento de complicaciones, y un abordaje multidisciplinario es necesario para disminuir esta morbilidad. The aim of this paper is to present the results after the use of parascapular free flaps to cover severe softtissue defects at the extremities. Methods: A retrospective, descriptive study of 20 patients who received parascapular free flaps to cover massive combined soft-tissue lesions at the extremities as a salvage procedure from 2006 to 2017 was performed. Patients' age averaged 30 years (18 men, 2 women). Sites of lesions were: ten at the forearm and wrist, one at the inguinal region, seven at the leg and two at the ankle/foot. Results: Follow-up averaged 3.6 years. Successful coverage was achieved in 17 cases. Flap size averaged 24.8 x 10.7 cm. There were six cases with neurovascular lesions that needed grafting, six cases had associated bone loss, eleven patients needed skin graft and four required tendon reconstructions. Donor area closed primarily without functional limitations in all patients. In three cases the flap was combined with a scapular flap and in three cases with a latissimus dorsi flap. Two flaps failed and the injured limb was amputated; one patient died due to massive embolism seven days after surgery. Conclusions: Parascapular free flaps allowed salvage and reconstruction of 17 out of 20 severely injured limbs, without morbidity for the donor area. But its use is not free of complications, and a multidisciplinary approach is necessary to reduce this morbidity.

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“…5,12 Because of its relative ease to harvest and a size of up to 45 Â 12 cm it became one of the most popular free flaps in reconstructive surgery. [13][14][15][16] Vascular abnormalities are demonstrated in less than 5% and, with respect to the subscapular vessel axis, it can be combined with scapular flap and scapular bone, latissimus muscle as well as serratus muscle and rib, making the PS flap a reliable and versatile tissue transplant for reconstructive purposes. [17][18][19][20][21] Regarding donor-site morbidity, Roll et al showed acceptable results after harvest of fasciocutaneous as well as osteofasciocutaneous PS free flaps in 20 patients.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Donor-Site Morbidity and Satisfaction between Anterolateral Thigh and Parascapular Free Flaps in the Same Patient

Fischer

Klinkenberg

Behr

et al. 2013

J reconstr Microsurg

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The purpose of this study was to compare donor-site morbidity after anterolateral thigh (ALT) and parascapular (PS) free flap harvest in the same patient. A total of 13 patients were included in this study. Because of initial flap loss, each patient received ALT as well as PS free flap transplantation. A total of 10 patients were available for follow-up. The average follow-up time was 44.5 months. Besides physical examination, range of motion and scar dimensions were assessed to objectify donor-site deficiencies. The subjective donor-site morbidity was assessed by the patients using a self-report questionnaire. In addition, patients were requested to state their donor-site preference. ALT donor site revealed more sensitivity deficiencies compared with the PS harvest site (8 vs. 4). The latter provoked less functional impairments (1 vs. 2). Scar dimensions were larger at PS harvest site (25.8 × 4.3 cm vs. 23.3 × 3.6 cm). Patients' satisfaction was in favor of the PS donor site (1.9 vs. 2.7). Among the 10 patients, 7 patients preferred the PS and 3 patients preferred the ALT donor site. Comparison of donor-site morbidities in the same patient reveals a valuable tool to diminish individual bias. Despite the low number of cases, we were able to demonstrate the superiority of PS compared with ALT donor sites.The Level of Evidence of the study is III.

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Lateral extension of the free scapular flap

Cited by 14 publications

References 7 publications

Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

Colgajo paraescapular en pérdidas postraumáticas de tejidos blandos de las extremidades. [Parascapular flap in post-traumatic soft-tissue loss at the limbs.]

Comparison of Donor-Site Morbidity and Satisfaction between Anterolateral Thigh and Parascapular Free Flaps in the Same Patient

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