Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Usefullness of Chimeric Flaps Based on the Subscapular Vascular System

견갑하 혈관경을 기저로 하는 키메라 피판의 유용성

  • Kim, Hyon Surk (Department of Plastic and Reconstructive Surgery, Korea University College of Medicine) ;
  • Lim, Hyung Woo (Department of Plastic and Reconstructive Surgery, Korea University College of Medicine) ;
  • Park, Seung Ha (Department of Plastic and Reconstructive Surgery, Korea University College of Medicine) ;
  • Lee, Byung Il (Department of Plastic and Reconstructive Surgery, Korea University College of Medicine)
  • 김현석 (고려대학교 의과대학 성형외과학교실) ;
  • 임형우 (고려대학교 의과대학 성형외과학교실) ;
  • 박승하 (고려대학교 의과대학 성형외과학교실) ;
  • 이병일 (고려대학교 의과대학 성형외과학교실)
  • Published : 2009.09.15
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Abstract

Purpose: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. Methods: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. Results: Defect sizes ranged from $6{\times}8cm$ to $20{\times}22cm$. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. All cases were successfully reconstructed without additional operative procedures or flap necrosis. Conclusion: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one - stage reconstruction tailored to the characteristics of the defect area.

Keywords

References

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