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The expanded scapular flap

R C Russell1, R K Khouri, J Upton

  • 1Southern Illinois University School of Medicine, Institute for Plastic and Reconstructive Surgery, Springfield, USA.

Plastic and Reconstructive Surgery
|September 1, 1995
PubMed
Summary
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Flap expansion increases the size of scapular fasciocutaneous flaps, enabling coverage of large soft-tissue defects. This technique augments blood supply, making larger flaps viable for reconstruction.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Tissue Engineering

Background:

  • Scapular fasciocutaneous flaps are reliable for free tissue transfer but limited by size.
  • Chronic soft-tissue defects often require large flaps for adequate coverage.

Observation:

  • Fourteen patients underwent pre-transfer expansion of scapular fasciocutaneous flaps for 6-12 weeks.
  • Flap sizes ranged from 96 to 1885 cm², used for chronic soft-tissue defects.
  • Twelve flaps were free transfers, two were pedicled flaps to the ipsilateral extremity.

Findings:

  • All expanded flaps survived, with minor marginal necrosis in three cases.
  • Two microsurgical flaps required revision due to arterial thrombosis.
  • Three patients experienced donor site wound dehiscence, managed conservatively or with skin grafts.

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Implications:

  • Flap expansion enhances blood supply, allowing larger fasciocutaneous flaps to survive on a single vascular pedicle.
  • This technique is beneficial for patients needing large, thin flaps when sufficient expansion time is available.
  • Pre-transfer expansion offers a viable option for reconstructing extensive soft-tissue defects.