[Microsurgical reanastomosis of scapula transplants for maxillofacial bone reconstruction]

Between 1989 and April 1993 29 grafts from the scapula region have been harvested for reconstruction in the head and neck area. 7 out of 20 osteocutaneous grafts have been used for reconstructions in the maxillary/midface area. In this area, one graft was completely lost due to venous congestion and another loss of the soft tissue component of one graft occurred. The complication rate in the maxilla seems to be higher than in application of the flap for mandibular reconstruction. Reconstruction in the maxillary/midface area most often requires several surgical steps. In special situations, as for example when unfavorable conditions regarding the recipient vessels exist, primary soft tissue reconstruction with a technically less demanding flap and a longer vascular pedicle (for example m. latissimus dorsi) and secondary free bone grafting may be indicated.