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CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2778-4044
Case Report

Novel Use of Chimeric Serratus Anterior Fascia–Latissimus Dorsi Flap for Composite Cranial Defect

Autor*innen

  • James Antongiovanni 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States
    2   Washington State University, Elson S. Floyd College of Medicine, Spokane, Washington, United States

  • Nikhil Shah 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States

  • Chizoba A. Mosieri 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States
    3   Louisiana State University Health Shreveport School of Medicine, Shreveport, Los Angeles, United States

  • Sarah Struble 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States

  • Hoyune E. Cho 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States

  • Medha Vallurupalli 

    4   University of Southern California, Keck School of Medicine, Los Angeles, California, United States

  • Gabrielle Labove 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States

  • Miles J. Pfaff 

    1   Department of Plastic Surgery, University of California, Irvine, School of Medicine, Orange, California, United States
    5   Children's Hospital of Orange County, Orange, California, United States
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Abstract

Effective soft tissue coverage is essential for minimizing complications in large cranial defects. This case report describes the successful application of a chimeric serratus anterior fascia–latissimus dorsi (SAFLD) flap for single-stage coverage of a large cranial defect. This technique is compared to the current literature. A 69-year-old female with a history of glioblastoma and a rapidly growing scalp squamous cell carcinoma underwent en bloc resection and single-stage reconstruction. After cranioplasty, a large defect was covered with an SAFLD flap, ensuring multilayered vascularized soft tissue coverage. Recovery was uneventful, and a 1-year follow-up demonstrated good cranial morphology. This case demonstrates the successful application of a chimeric free flap for dual-layer coverage in cranial reconstruction, potentially reducing complications associated with single-stage repairs and improving patient outcomes. A literature review demonstrating various case applications of this flap is also presented.

Keywords

cranioplasty - chimeric free flap - calvarial reconstruction - craniotomy - multilayer scalp reconstruction

Contributors' Statement

J.A.: Data curation, investigation, writing–original draft, writing–review and editing. N.S.: Conceptualization, data curation, investigation, methodology, visualization, writing–original draft, writing–review and editing. C.A.M.: Investigation, writing–original draft, writing–review and editing. S.S.: Software, writing–review and editing. H.E.C.: Conceptualization, investigation, methodology. M.V.: Writing–original draft. G.L.: Conceptualization, investigation, methodology. M.J.P.: Conceptualization, methodology, project administration, supervision, writing–review and editing.


Ethical Approval

Ethical approval was not required for this study in accordance with institutional guidelines, as this manuscript represents a single-patient case report and does not constitute human subjects research.


Informed Consent

Informed consent was provided, and the patient agreed to the use of their photos and medical information as it pertained to their diagnosis and reconstruction for this manuscript.




Publikationsverlauf

Eingereicht: 21. März 2025

Angenommen: 22. Dezember 2025

Accepted Manuscript online:
05. Januar 2026

Artikel online veröffentlicht:
05. März 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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