Transfer of the scapular flap on a reverse latissimus muscle pedicle

In a series of six clinical cases, the scapular flap was transposed to the lower torso using the reversed latissimus dorsi muscle flap as a carrier. There were two complete failures and one partial flap loss, which may have been caused by venous valves, although this possibility was not recognized until late in the series. In the absence of anomalous vessels and when there are no valves, the use of this flap combination can be quite simple and results in an extremely versatile block of tissue for repair of defects that might otherwise require free flaps. However, the surgeon must be prepared to resort to microvascular techniques when anatomic problems are encountered.