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The scapular osteofasciocutaneous flap: a 12-year experience
M L Urken1, A G Bridger, K B Zur
1Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY 10029, USA. mark.urken@mssm.edu
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.