Abstract
Management of complicated open wounds of the extremities represents a reconstructive
challenge. The goal of reconstruction is to provide coverage of exposed vital structures
with well-vascularized tissues for optimal restoration of its form and function. We
present our experience with the use of scapular fascial free flaps in the reconstruction
of complicated open wounds of the extremities. During the period 2001 to 2009, a total
of 12 reconstructions utilizing scapular fascial free flaps were performed: nine for
upper extremity wounds and three for lower extremity wounds. Two flaps failed: in
one case due to intractable vasospasm, in the other case due to lack of adequate recipient
vessels. In the ten successful cases, good functional and aesthetic outcomes were
achieved. Based on our experience, we conclude that the scapular fascial free flap,
although technically demanding, could be considered as the flap of choice for reconstruction
of complicated open wounds of the extremities; it provides ample thin and well vascularized
soft tissue coverage with restoration of function and a natural contour of the extremity.
Keywords
scapular fascial free flap - complicated wounds - extremity reconstruction - hand
reconstruction