Review of the free scapular flap: a versatile flap for most osteocutaneous tissue defects

Abstract

Although there is little doubt that the scapular flap is a versatile flap that is suitable for most tissue defects, it has failed to gain its proper place in the reconstructive armamentarium. This may be due to the perceived donor site morbidity. However, many published articles have shown that the donor site morbidity is limited and acceptable. The scapular free flap is accessible, relatively easy to dissect and has a long vascular pedicle with a constant position of artery and veins. The donor site may be closed primarily for flaps that do not exceed 10 cm in width. It is usually hairless, and is ideal for intermediate-sized defects. There is no functional donor site deficit and the resulting scar is acceptable. No major artery is sacrificed. The independent arc of skin flap rotation relative to the bone component is another major advantage over other flaps. Therefore, I believe that the scapular free flap is a superior and adaptable flap in most skin and/or bone defect reconstructions.

Tailored Skin Flaps for Hand Reconstruction

“…The scapular and scapular-parascapular flaps are other thin and foldable flaps that can cover large defects. They are based on the descending and transverse branch of the circumflex scapular artery's vascular supply, 49,50 but despite being relatively easy to dissect, having a large caliber vascular pedicle with a constant position of the artery and veins‚ 51 and having a low donor site morbidity 52 are not widely used today, possibly due to the side positioning and increased rates of seroma. We used the scapular flap in one patient and a combination of scapular and parascapular flaps in two patients.…”