Domino Flap Using Bilobed Flap for Large Scapular Flap Donor Site: A Case Report

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Scapular flaps are commonly used for extensive soft tissue defects.
• However, harvesting these flaps carries a significant risk of shoulder contracture.
• Current techniques for donor site closure may limit flap size or lead to morbidity.

Purpose of the Study:

• To present a novel application of a bilobed flap for closing the donor site after scapular flap harvest.
• To evaluate the efficacy of this technique in preventing shoulder contracture and minimizing donor site morbidity.
• To report the use of the largest bilobed flap documented to date.

Main Methods:

• A 23-cm scapular flap was harvested to cover a large degloving injury.
• A bilobed flap was utilized for the primary closure of the scapular donor site.
• Patient outcomes, including shoulder range of motion and flap viability, were assessed postoperatively.

Main Results:

• The patient achieved full range of motion in the shoulder after 6 months.
• The scapular flap remained viable, and the patient regained good hand function.
• The bilobed flap successfully closed the large donor site defect with minimal complications.
• This represents the largest reported bilobed flap for donor site closure.

Conclusions:

• The bilobed flap technique is an effective method for closing scapular flap donor sites.
• This approach prevents shoulder contracture and enables larger scapular flap harvests.
• The technique offers a valuable option for managing donor site defects in reconstructive surgery.